Rheumatoid arthritis is a chronic autoimmune condition that causes joint pain and inflammation. It may also lead to dental problems.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that most noticeably causes joint pain, swelling, and inflammation. There are also other less noticeable problems that can arise from RA, including effects on your teeth and oral health.

Your jawbone, teeth, and other oral structures need a strong support system, and RA can make regular brushing and flossing more difficult.

Certain medications used to treat RA — as well as other health conditions — can also lead to dry mouth and cause other oral and dental problems. While that may not happen often as a result of RA medication use, consulting a healthcare team can be an important way of determining possible side effects for any prescription or over-the-counter medications.

This article will explore some of the most common oral and dental issues that can develop in people who have RA and what steps you can take.

Bone loss associated with RA can certainly affect your oral health. RA is an autoinflammatory disease that affects your entire body.

Although changes might be most noticeable in your joints where the pain and inflammation are most pronounced, bone destruction and decay can happen in many other areas of your body too.

Below are some of the main ways RA can cause problems for your oral health.

Periodontal disease

Periodontal disease may be a trigger for RA in some people.

This is a chronic inflammatory disease triggered by a film of bacteria that can develop on your teeth and gums. Eventually, this bacterial growth leads to inflammation and tissue damage. Your collagen-rich tissues are most at risk of damage from both RA and periodontal disease.

In RA, this loss can happen in your:

  • bone
  • cartilage
  • tissues around your joints (periarticular tissues)

In periodontal disease, damage can occur to:

  • the ridge of bone that holds your teeth (alveolar bone)
  • the ligaments that hold your teeth in place (periodontal ligaments)
  • your gums (gingiva)

Temporomandibular joint (TMJ) problems

Temporomandibular joint (TMJ) dysfunction is a common issue in people with RA.

The TMJ is used more than 2,000 times per day for chewing and speaking. Between 5% and 86% of people with RA are believed to have discomfort in this joint.

One study found:

  • About 45% of people with RA who experienced TMJ problems had difficulty chewing.
  • About 40% had to make changes to their diet because of these chewing problems.
  • About 30% had pain with eating.
  • About 36% took pain medication for TMJ-related issues.

Dry mouth

Autoimmune conditions like RA and Sjögren’s disease are also common causes of problems with your salivary glands.

Salivary gland problems that result in dry mouth — and eventually cause additional issues like cavities — occur in roughly 30% to 50% of people with RA.

On top of physical problems with your salivary glands that could lead to dry mouth, certain medications used to treat RA and its associated conditions can cause dry mouth as a side effect.

Specific arthritis medications that can cause the saliva glands in your mouth to dry out are nonsteroidal anti-inflammatory drugs (NSAIDs), including Celebrex.

Other medications that may cause dry mouth, but aren’t specifically for RA include:

RA is a chronic disease where your body attacks its own cells, causing damage and decay over time in your bones, joints, and other tissues.

RA can cause pain and inflammation, usually in more than one joint of your body — and this could be any joint. The TMJ is what moves your jawbone as you speak and chew. Problems in this joint can be painful and particularly difficult to endure since there’s nothing you can really do to avoid using this area.

Although TMJ bony deconstruction can be an issue, it’s rare for adults whose inflammatory symptoms are well controlled.

There’s also decay that can happen with your jawbone due to the RA disease process as well as medications used to treat RA.

The term medication-related osteonecrosis of the jaw was first used to describe jawbone damage from certain medications in 2014. It specifically describes damages to your jawbone that can happen when you use certain medications.

Teeth that are extracted and replaced with dental implants require new bone growth to occur in order for the implantation to be successful. In people with RA, or people who take certain medications to treat RA, their bone growth is slow or nonexistent.

Some studies show a higher rate of dental implant failure in people with RA or those who are treated for RA compared with people without the disease. But having RA or Sjögren’s disease doesn’t mean you can’t get dental implants. A dental or rheumatology specialist can help guide you on the possible risks and benefits.

Dental extractions are sometimes needed to address oral health problems.

If you need to have a tooth pulled and you have RA, you may experience some additional complications.

But depending on the reason you’re having a tooth extracted, those issues might not be a reason to avoid the extraction. Delaying a tooth extraction that’s necessary for treating things like infection could cause you a host of other problems.

Talk with a dentist or healthcare professional about your individual reasons to have and risks with a tooth extraction. RA and the medications used to treat it are rarely a reason to delay or cancel a tooth extraction.

RA doesn’t affect your teeth directly.

It’s a disease that attacks the cells that make up your bones, joints, and connective tissues. This means that RA can affect your gums and overall dental health, but not your teeth specifically.

Certain medications that are used to treat RA can cause you dental problems.

Medications called disease-modifying antirheumatic drugs (DMARDs) that suppress your immune system are the primary treatment for RA.

While these medications do a good job in reducing RA pain and inflammation, they can also increase your risk of infection and potentially cause you to lose bone density.

All of these things could possibly contribute to tooth pain, especially if you develop oral infections or loose teeth as a result.

Pain is a big part of RA. Although some medications used to treat RA inflammation may reduce pain, you may also be prescribed NSAIDs or other pain relievers as well. These medications can treat many types of pain and should help with any dental pain you have as well as RA pain.

If you experience tooth pain as your only symptom, it might not be caused by RA.

But if you’ve received a diagnosis of RA and you begin having tooth pain, talk with a healthcare team or dentist. They may be able to rule out more complex causes of pain or infection, especially if you have RA and are taking medications that can suppress your immune system.

RA is a chronic disease that causes your body to attack its own joints and bones. Any joints and bones can be affected, including those in your jaw and mouth.

If you have RA, it’s important to take steps to prevent infections and other forms of inflammation in your mouth with good dental hygiene. There’s a chance any tooth extractions or implants could be made more difficult by RA and the slow bone growth associated with it, but a dentist or healthcare team can help you take steps to reduce your risk of complications.