Treat Gum Disease to Relieve RA Pain and Stiffness

A thorough dental cleaning can control symptoms.


One of the best weapons against the swollen, painful joints that characterize rheumatoid arthritis (RA) may just be the dentist’s chair.

Researchers at Case Western Reserve University in Cleveland, OH, split 40 people with severe RA into two groups: One was given a “deep” nonsurgical dental cleaning, in which bacteria are scraped from the root surface and from under the gum line and tartar is removed from the teeth. The other group got instructions from a dentist about how to keep their teeth clean at home.

Within six weeks, the group that had the professional cleaning had significantly less pain and morning stiffness and fewer swollen and painful joints than the group that cleaned their teeth at home. Even more impressive, researchers found that the deep cleaning actually decreased levels of tumor necrosis factor-alpha, an inflammatory protein in the blood that triggers inflammation. 

“If you get rid of inflammation and infection in the mouth, you subdue it in the joints,” says Nabil Bissada, chair of the Department of Periodontics, who led the study.

If you have RA, but don’t have deep pockets under the gum line, Bissada says a regular professional cleaning should suffice.

Dr. Bissada joined forces with Ali Askari MD, chair of the rheumatology department at the University Hospitals of Cleveland, to study the relationship between periodontal disease and RA.

This time the researchers split 40 people – all with both severe RA and moderate to severe periodontal disease – into four groups. Two groups received biologic drugs that block the production of tumor necrosis factor-alpha (TNF-alpha). The other two groups did not receive these drugs.

Researchers provided standard, nonsurgical periodontal treatment to one set of participants from both the drug and non-drug groups during the study. The other sets received treatment after the study ended.

RA symptoms improved for all patients receiving the periodontal treatment, whether they were on the anti-TNF-alpha drug or not. Those who did receive TNF inhibitors showed a greater improvement in symptoms.