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                                                        DR. DAN PETERSON

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ARTHRITIS  AND DENTAL CARE 

Arthritis Affects New Solutions
Arthritis Related to Gum Disease At The Dentist
Perio Linked to Arthritis Treatment
Arthritis News Updates

                                     Arthritic trying to brush with regular toothbrush.                                            Sonicare is much easier to grip and use to promote good oral health.*

Arthritis affects your dental health. It can affect your jaw joints which can affect your ability to chew. As the disease progresses it can become more difficult to do your daily routine care such as brushing your teeth and/or flossing your teeth.

    We recommend individuals with arthritis use Sonicare toothbrush.  It has:

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 A larger handle that makes it easier to grasp.

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 Helps you reach areas of your mouth that are hard to reach.  

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 Sonic action that is more precise in cleaning your teeth.

     Both the American Dental Association and American Hygienist Association recommend Sonicare especially for individuals who suffer from arthritis.

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    We also recommend the automatic flosser by Waterpik~.  It makes flossing easy, quick and  convenient.

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News Updates

Association Between Periodontitis and Rheumatoid Arthritis

An Australian study published in the Journal of Periodontology found that participants who had rheumatoid arthritis were more than twice as likely to have periodontal disease with moderate to severe jawbone loss as patients in the control group. In addition, they averaged 11.6 missing teeth compared with 6.7 in the control group. A higher percentage of participants with rheumatoid arthritis had deeper pocketing. Researchers are not stating that the relationship between the two diseases is causal; however, some scientists think a bacterial infection may trigger the disease process in some with rheumatoid arthritis. 2/06

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Rheumatoid Arthritis and Periodontal Disease May Be Associated

An Australia study found that prevalence of rheumatoid arthritis was 3.95% in the periodontal treatment groups versus 0.66% in the general dental treatment group.  In addition, 62.5% of periodontal patients with rheumatoid arthritis suffered from ADVANCED DISEASE.

The periodontal group also reported a higher prevalence of  cardiovascular disease and diabetes mellitus.  Patients with more advanced periodontal disease were at higher risk of having rheumatoid arthritis and vice versa.  This study concluded there are some pathogenetic similarities between the two chronic inflammatory disease.
Year Book of Dentistry 2001, Dentistry Today, pg 38 Jan 2002

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Periodontal disease linked to arthritis:

     A study showed that people who have rheumatoid arthritis were:

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More than twice as likely to have periodontal disease.

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Likely to have moderate to severe jawbone loss.  

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They also averaged 11.7 missing teeth, compared to 6.7 in the control group.  

     Some scientists think a bacterial infection may trigger the disease process in some of the estimated 2.1 million people with rheumatoid arthritis.  Additional information can be obtained from the American Academy of Periodontology

Source: AGD Impact, August/September 2001 pg 17

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MAJOR REVIEW REVEALS THAT OSTEOARTHRITIS IS A COMPLEX DISEASE WITH NEW SOLUTION

Osteoarthritis (OA) is a major public health problem, affecting some 20 million people in this country.

Serious joint injury can lead to osteoarthritis (OA), but more often the disease results from a combination of systemic and joint-related factors.  OA is strongly genetically determined, with genetic factors accounting for about half of OA in the hands and hips and a smaller percentage of OA of the knees.

The disease is responsible for more trouble walking and stair climbing than any other disease, and it is the most common indication for total

 joint replacement of the hip and knee. Before age 50 the prevalence of OA in most joints is higher in men than women.   After this age, more women are affected by OA of the hand, foot and knee.  The occurrence of the disease increases with age, rising 2- to 10-fold in people from 30 to 65 years of age.

     In osteoarthritis, there is focused, progressive loss of cartilage, the slippery material that cushions the ends of bones, along with changes in the bone below the cartilage leading to bony overgrowth.  The tissue lining of the joint can become inflamed, the ligaments looser, and associated muscles weak, with resulting pain when the joint is used.

      A multidisciplinary group of scientists has declared that osteoarthritis (OA), the most common form of arthritis, is "surprisingly complex,".

At Your Dentist

Many patients with rheumatoid arthritis take high doses of aspirin or other non-steroidal anti-inflammatory drugs. These drugs can increase bleeding and possibly cause hemorrhage after surgical dental procedures. Some people may be taking D-penicillamine, steroids or other drugs that can weaken the immune system.

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 Give your dentist a list of your medications and their doses and let him or her know about any drug sensitivities or allergies you may have.

If your temporomandibular joint is involved in your arthritis, it may be difficult for you to undergo very long dental procedures. 

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You can have a few short appointments instead of one long one or if the appointment is for elective dental care, you can wait until you feel better.

Steroid therapy is also common in people with rheumatoid arthritis. People on long-term steroid therapy may not be able to cope with stress as well unless they take a replacement dose of steroids. 

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If you have been on steroids for more than a few weeks or if you have a history of stress reactions after dental treatment, you may need to take additional steroids before long or stressful treatment.

If you have had joint replacement, your dentist may give you antibiotics before dental treatment to prevent a bacterial infection in the joint.

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 If you are scheduled for joint replacement surgery, consider having all necessary dental surgeries before the replacement to avoid the need for antibiotics

     Once OA develops, certain factors put a patient at risk for  disability.  These include pain, depression, muscle weakness and poor aerobic capacity.   

  1. MEDICATIONS

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Acetaminophen can help mild or moderate joint pain in OA.

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The next drugs of choice are tramadol and nonsteroidal anti-inflammatory drugs (NSAIDs).The use of NSAIDs is often associated with problems in the gastrointestinal (GI) tract and kidney problems.  

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Celecoxib and rofecoxib.

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Opioid painkillers can also be used in patients with OA.

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Exercise is important in people with OA.  

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Shock-absorbing footwear.

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Try sticking the handle of a toothbrush or flosser device through a tennis ball to help you grasp these items comfortably.

Patient education "the cornerstone" of osteoarthritis treatment.

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Updated Material

The Dental Infections, Gum Disease Produces Astonishing Blood Changes

Dr. Price noted patients suffering from rheumatic disease were prone to the withering away of their tissues. The emaciation could range from 10 to 25 percent in ordinary cases and 35 to 40 percent in extreme ones. He reported that one woman patient who had a normal weight of 130 dropped to 72 pounds. Upon removal of her dental infections, her weight quickly climbed from 72 pounds to 111.

George Meini.From: http://www.dailyindia.com/show/1235.php   February 06, 2006

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Association Between Periodontitis and Rheumatoid Arthritis

An Australian study published in the Journal of Periodontology found that participants who had rheumatoid arthritis were more than twice as likely to have periodontal disease with moderate to severe jawbone loss as patients in the control group. In addition, they averaged 11.6 missing teeth compared with 6.7 in the control group. A higher percentage of participants with rheumatoid arthritis had deeper pocketing. Researchers are not stating that the relationship between the two diseases is causal; however, some scientists think a bacterial infection may trigger the disease process in some with rheumatoid arthritis.

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People With Rheumatoid Arthritis Have More Periodontal Disease

      Swollen joints and missing teeth often go hand in hand. A new study found that people who had rheumatoid arthritis were more than twice as likely to have periodontal disease with moderate to severe jawbone loss.  They averaged 11.6 missing teeth, compared to 6.7 in the control group.

Periodontal disease and rheumatoid arthritis have very similar pathologies, damage caused by the immune system and chronic inflammation are central to both diseases.

People with rheumatoid arthritis should be on a close lookout for signs of periodontal disease, such as red, swollen gums that bleed easily. The earlier you detect periodontal disease and treat it, the better off you are."
Journal of Periodontology,  Robert Genco, D.D.S., Ph.D

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Source:

The mission of the NIAMS is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research and the dissemination of information on research progress in these diseases. For more information about NIAMS, call our information clearinghouse at 1-877-22-NIAMS or visit the NIAMS Web site at http://www.nih.gov/niams.

February 27, 2007

~We have NO financial investment in any of these products.

*Geriatric Hygiene. Dr. Shapiro, Dentistry Today March 2001. pg 54-59

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
This site is privately and personally sponsored, funded and supported by Dr. Peterson.  We have no outside funding.
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