Oral health is an important part of systemic health. We are beginning to understand more and more links between poor oral health and other diseases of the body such as the link between gum disease and respiratory or cardiovascular disease. Recent research has indicated an association between chronic incurable diseases like gum disease and rheumatoid arthritis and ankylosing spondylitis. Anyone who has experienced these types of arthritis firsthand or in a family member or friend understands how life changing it can be.
Ankylosing spondylitis is an autoimmune disease which causes chronic inflammation of the joints, mainly the spine and the pelvis, and can cause eventual fusion of the spine. Men are affected more than women in a ratio of 3:1. It is a very painful condition.
Spondylitis can affect the temporomandibular joint. About 10% of those affected with ankylosing spondylitis experience limited movement of the TMJ. Loss of teeth due to gum disease or cavities can alter the bite leading to further degeneration of the joint. Clenching and grinding teeth can aggravate the TMJ pain as well. The majority of those with TMJ pain achieve relief of symptoms with conservative treatment. Spondylosis can lead to osteoporosis which can affect bone remodeling leading to loss of teeth and TMJ problems and even jaw fractures. Depending on the degree of osteoporosis activity, rheumatologists or physicians may prescribe bisphosphonate which prevents bone deterioration. This drug runs a slight risk of causing osteonecrosis (unhealing or crumbling of the bone) if the patient gets a tooth removed. So, it is extremely important for the dentist to know if you ever had to take bisphosphonate therapy.
Spondylitis can cause secondary Sjogren’s Syndrome that leads to dryness of the eyes and mouth. The salivary glands may get swollen. Dry mouth causes severe tooth decay and gum disease because saliva is important in remineralization of the enamel, which in turn protects the enamel surface from getting destroyed by the bacteria in the mouth. A strict regimen of oral hygiene is important along with salivary replacement therapy to protect the teeth and the gums.
Therefore, your visit to the dentist is important to the health of the rest of the body, not just your teeth and gums and at your initial dental appointment, it is important to discuss your health history with your dentist. Early intervention can lead to appropriate preventative management thereby minimizing negative health consequences of tooth decay or gum disease leading to loss of teeth.