Oh, My Aching Teeth

Last updated: September 2019

It would not be an exaggeration to say that my dental woes are on par with my RA issues. Now, how much one impacts the other is an age-old question. Honestly, I have had problems with my teeth from childhood so I am certain that I cannot attribute the fact I had a lot of crowns before my 21st birthday to RA since it did not rear its ugly head until my 40’s. That said, the fact that I have had over a dozen root canals, 5 implants (which involve extractions), TMJ and dry mouth may well be thanks to the RA. 

What is Sjogren’s syndrome?

Sjogren’s syndrome is quite common in folks with RA and is a strong contributor to mouth and gum issues. Sjogren’s is an autoimmune condition that is often a complication of another autoimmune disease, like RA. One of the most prevalent symptoms is dry mouth due to lack of saliva production.

This can lead to gum and dental complications that can be ongoing and challenging to contend with. I have been told by my dentist and oral surgeon over the years that many of my dental issues are directly connected to Sjogren’s and RA.

Dental issues due to RA and Sjogren's

What is idiopathic tooth pain?

I developed a condition called idiopathic tooth pain or atypical odontalgia. This means I have pain in a tooth that has no direct relationship to a traceable tooth problem. Despite having a root canal in the tooth and no abscess, infection, cavity or gum disease, I have pain in a tooth that comes and goes on a regular basis. Kind of like an RA flare in my tooth! I have had hours of work on it by dental specialists and they all now agree on the diagnosis. 

Atypical odontalgia is akin to phantom limb syndrome in an amputee. In the same way one may experience pain in a limb that has been amputated, people who have atypical odontalgia feel pain in a perfectly healthy tooth, even one that has been extracted. I was shocked to hear this condition existed, only to discover it can go along with the tooth issues associated with Sjogren’s syndrome.

I have had dry mouth, TMJ and gum discomfort for years and when I think back, I can trace the start of it to within a few years of manifesting RA.

How I manage the tooth pain

Lozenges for mouth dryness

So with all of that said, how do we handle this? Well, I utilize several strategies. First, to relieve the almost non-stop dryness, I have lozenges suggested to me by my dentist that are available OTC at any drugstore in the same section as a mouthwash. They work really well and do give me relief. 

Limit substances that lead to mouth dryness

In addition, limiting beverages that dry the mouth, like excess alcohol, is helpful. A number of mouthwashes have alcohol so be sure to get one that does not have it. That goes for toothpaste as well. 

Schedule regular dentist visits

I also see my dentist at least every 6 months, although I am there more often than that most of the time! Having professionals check on your gums and teeth is crucial to maintaining dental hygiene. It is important that your dentist be aware of your RA and the medications you take. All of that gives them a more complete picture to work with in suggesting treatment.

Sjogren’s is a tricky condition but with careful and consistent collaboration with your dental care team and your RA care team you can manage it.  I continue to hope that my dental woes will lessen as I learn how to more effectively treat them.  I will keep that thought.


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