Psoriatic arthritis and dental health: Links and more

Research suggests that periodontitis may play a role in causing or worsening psoriasis. There is also a link between periodontitis, disease severity, and whether someone with psoriasis develops PsA.

One 2019 review suggests that the following factors may be predictors of psoriasis:

• a family history of psoriasis
• oral pain within the last 12 months
• poor gum health
• speech difficulties due to dental issues

2019 research shows that people with gum disease tend to have higher rates of inflammatory conditions.

Oral health may also be more challenging for people with a painful, chronic condition such as PsA. Further research will help experts better understand the link between PsA and dental health.

Psoriatic arthritis and periodontal disease

A 2021 study found a possible link between the two conditions. Specifically, people with PsA were more likely to have severe stage III gum disease than those without PsA.

PsA causes inflammation that can worsen gum disease and hasten severe symptoms such as tooth decay.

People with psoriasis also have a higher risk of developing periodontitis compared to the general population, according to a 2019 review. They are also more likely to:

• have more severe gum inflammation
• experience more bone loss
• have more missing teeth

Drugs that treat immune-related conditions such as psoriatic arthritis may also affect a person’s immune system, putting them at greater risk of severe infections, including infections of the teeth and mouth that can cause tooth loss or worsen oral health.

Psoriatic arthritis and dental implants

Dentists may recommend dental implants for people with tooth loss, but some PsA drugs impact the immune system. This can make people more susceptible to infection and increase the risk of complications with surgery.

While there is no research on dental implants in people with PsA, a 2017 review suggests that implants have a higher chance of failing in people with rheumatoid arthritis, another form of arthritis that involves the immune system.

According to the World Health Organization (WHO), oral health problems affect almost 3.5 billion people worldwide.

The Centers for Disease Control and Prevention (CDC) recommend the following steps to maintain good oral health:

• using toothpaste that contains fluoride and drinking fluoridated water
• brushing twice a day
• flossing every day to control plaque to avoid gum disease or dental caries
• visiting the dentist at least once a year
• avoiding tobacco products and keeping alcohol to a minimum
• asking about alternative medications if current ones are causing dry mouth

The WHO also recommends eating a balanced diet filled with varied fruits and vegetables and opting for water as the main drink.

When to visit a dentist

A person experiencing dental pain or discomfort that impacts their ability to eat or speak as usual should consult a dentist.

The CDC also recommends regular dental exams to maintain good oral health. Visiting a dentist regularly and identifying problems early on can help prevent them from worsening.

PsA is an inflammatory condition that involves an overactive immune response. It causes joint swelling, pain, and stiffness. Untreated, the condition can also cause lasting joint damage.

Research suggests a link between PsA and poor dental health, but experts are not sure why this is the case. Inflammation may play a role.

It is essential for people with chronic inflammatory conditions such as PsA to monitor their dental health and inform their dentist about their condition and any medications they are taking.