A Bout of Three Cavities
Last updated: April 2023
Recently, I had a routine dentist appointment that went a little awry. For the past 22 years, I have had a pretty clean track record with my dentist with having only 2 cavities thus far; however, during this last checkup, my dentist noticed the beginnings of 3 more cavities and some gum issues, with the hygienist even checking to see if my gums were still in tack (they were, thankfully).
While my teeth are still relatively strong and healthy, it perturbed me that these problems were occurring, particularly when I take good care of my teeth. Even before being diagnosed with RA, I was regularly brushing twice a day, flossing once a day, and swishing mouthwash twice a day. It left me wondering: could my RA and my Humira medication be causing these symptoms?
What triggers RA dental issues?
I called my rheumatologist when I returned home and informed him of what had happened at the dentist. He said that it was possible that both the Humira and Plaquenil were indirect sources of my recent teeth troubles. The rationale behind this was that these medications were causing dry mouth and subsequently leading to a proliferation of bacteria, which thereby created the beginnings of those cavities.
Monitoring tooth decay and other dental issues
However, my rheumatologist also said that the RA itself could be exacerbating these dental problems by leaving me susceptible to bacterial infections of the gums. He told me to keep taking my medication and, if things progressed when I went back to the dentist, we would reconsider whether taking Humira and Plaquenil was the best treatment plan for me.
Oral and teeth decay with rheumatoid arthritis
Given this from my rheumatologist, I decided to do some further research. Apparently, I am not alone in experiencing these side effects; in fact, they're actually quite common. Many people have discussed how after being diagnosed with RA, their perfect track record at the dentist was subsequently sullied.
Sjorgen's syndrome, another culprit
Their rheumatologists have also informed that it could be a combination of medication and RA, although most pointed to the possibility of having Sjorgen's syndrome, as well, since dry mouth is the hallmark symptom of Sjorgen's. In my own experience with comorbidities, I have noticed that I have extremely dry eyes and dry mouth, so when I follow up with my rheumatologist next month, I'll request an ANA panel screening to see if there could be something else happening.
Improving side effects
Additionally, in my research, I found there are many potential remedies for these problems. The most common ones included buying Biotene mouthwash and toothpaste, drinking more water, and a fluoride prescription. My plan now is to purchase some Biotene products and see if they help any when I go back to the dentist in six months. Hopefully, it will!
This experience ultimately reminded me that RA is much more than swollen joints; it affects the entire body and can be an instigator for many other chronic conditions. It also demonstrated the importance of having a rheumatologist who can support you through the extraneous, unexpected, and sometimes weird side effects of RA.
Did you know rheumatologist Dr. Donica Baker is answering community questions?
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