A recent article posted to the Musculoskeletal Network, written by Anne Grete Semb MD, PhD, reviews some facts related to carotid plaques and rheumatoid arthritis. While this is topic is not of specific interest to dentists, one of the five things that it is suggested ‘to know” (Semb AG, Rollefstad S, Provan SA et al. Carotid Plaque Characteristics and Disease Activity in Rheumatoid Arthritis. J Rheumatol (2013) 40:4-10) relates to the relative risk of atherosclerotic plaques in RA patients. Why this is important to dentists is that jaw and TMJ pain can be caused by carotid inflammation associated with these plaques and this pain may be misdiagnosed as of dental origin.
rheumatoid arthritis
|
Diseases that are categorized as autoimmune in nature can cause mucocutaneous lesions characterized by oral ulceration, keratoses, desquamation, and bullae. Rheumatoid arthritis can also cause destructive lesions of the temporomandibular joint while Sjogren's disease is associated with xerostomia. The patient with scleroderma may experience progressive restriction of jaw opening as a component of this connective tissue disease. The following information relates to the dental management of some of the more common autoimmune diseases. Porphyromonas gingivalis (P Gingivalis) is a gram negative, non-motile and rod shaped anaerobic pathogenic bacteria that inhabits the oral cavity and the depths of the gingival sulcus. It is a primary cause of adult periodontal disease due to its propensity to produce collagenase which degrades the periodontium. In addition, it is known that the P. Gingivalis bacteria produces in the presence of the enzyme peptidyl arginine deiminase (PAD) citrullinated peptides in vivo (Rosenstein ED, et al. Inflammation, 2004). |
|
|