Oral bacteria can cause problems that reach far beyond the mouth. A study out of the Case Western Reserve University School of Dental Medicine followed the damage caused by bacteria after it leaves the mouth and enters the bloodstream.
Among the findings was data indicating that bacteria in fluid lubricating both knee and hip joints shared the DNA contained in dental plaques in patients with gum disease who need joint replacement.
A news release was issued on April 18, 2012, reporting that aseptic loosening or usage of artificial joints can fail within 10 years even when there is no sign of infection. Findings can be read in the April 2012 edition of the Journal of Clinical Rheumatology.
Researchers studied bacteria such as Fusobacterium nucleatum and Serratia proteamaculans to see if they were affecting patients with gum disease, whether they were found in the fluid. Findings seem to support a long-held theory that arthritis patients were being affected by the bacteria.
The study was performed with 36 patients with osteoarthritis and rheumatoid arthritis at the University Hospitals Case Medical Center.
Rheumatoid arthritis (RA) causes pain, swelling and stiffness in the joints. The joints can lose function. Wrist and finger joints are most commonly affected though any joint in the body can be targeted. RA affects women more often than men.
The age group most commonly hit is between 25 and 55 years old. Symptoms can come and go in milder cases. Severe cases of RA can experience lifelong symptoms.
The most common type of arthritis is osteoarthritis (OA). Joints experience pain, swelling and limited motion. The most commonly affected joints are the hands, hips, knees and spine, though any joint can be affected.
Cartilage, which is the slippery tissue covering the ends of bones in the joint, is damaged by OA. When cartilage is doing its job, it acts as a shock absorber. As cartilage diminishes, bones can rub together, and over time the joint becomes damaged.
If you are overweight, or have injured a joint, and as you age, your risk for osteoarthritis increases.
Patients in the study had natural and artificial joints. Their synovial fluid was examined. Synovial fluid is a lubricant of the joints. Dental plaque of these patients, who also had periodontitis (gum disease) was examined as well.
Plaque can break down walls of the pockets that surround the teeth. Bacteria caused an inflammation process allowing bacteria to enter the bloodstream. Inflammation spread to other areas of the body, playing a role in cancer, premature births, fetal deaths and diseases of the heart and kidneys.
Routine laboratory testing will not uncover these bacteria. But bacteria in the fluid and plaque can be detected through polymerase chain reactions and DNA sequence analysis of specific genes (16S-23S rRNA).
Of the 36 participants in the study, five showed a direct correlation between the DNA of the bacteria, and the DNA in the mouth's plaque and fluid.
One patient with rheumatoid arthritis had a failed natural joint, another with rheumatoid arthritis had a failed replacement.
Two patients with osteoarthritis had failed failed replacement joints. One patient with osteoarthritis had a failed natural joint.
It is worth noting that this was not a controlled study. People with periodontal disease who did not have joint disease were not tested. This means that researchers do not know whether or not it is normal for people with dental plaque bacteria to have it circulate in their joints.
Since the sample size and number of people affected is low in this research, more study is needed to determine if there is a connection between this aspect of oral health and joint problems.
Sources:
Identification of oral bacterial DNA in synovial fluid of patients with arthritis with native and failed prosthetic joints. PubMed. Retrieved April 28, 2013.
http://www.ncbi.nlm.nih.gov/pubmed/22426587
CWRU researchers find joint failures potentially linked to oral bacteria. Case.edu. Retrieved April 28, 2013.
http://blog.case.edu/think/2012/04/18/cwru_researchers_find_joint_failur...
Rheumatoid Arthritis. MedlinePlus. Retrieved April 28, 2013.
http://www.nlm.nih.gov/medlineplus/rheumatoidarthritis.html
Osteoarthritis. MedlinePlus. Retrieved April 28, 2013.
http://www.nlm.nih.gov/medlineplus/osteoarthritis.html
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Reviewed April 29, 2013
by Michele Blacksberg RN