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Healing Choices for RA, Issue #016 --Can gum disease aggravate RA
May 31, 2014

Can chronic gum disease induce rheumatoid arthritis or a flare?

RA patients with gum disease had more swollen joints and erosions in joints. They often had a positive Rheumatoid factor and other autoantibodies.[1]

The bacteria, Porphyromonas gingivalis commonly causes gum disease or gingivitis. If brushing your teeth or flossing causes bleeding gums, bacteria in your mouth are escaping into your bloodstream. Can those bacteria cause a problem? Probably.

Making proteins with citrulline

First, Porphyromonas gingivalis is one of the few bacteria that can convert arginine in a protein into citrulline. These citrullinated proteins look odd to the immune system of some people.

The citrulline proteins may then induce some people to make anti-citrullinated protein antibodies (ACPAs) or anti-cyclic citrullinated protein (anti-CCP) antibodies.[2, 3]

People with antibodies to these proteins (ACPAs and / or anti-CCPs) have a higher chance of developing rheumatoid arthritis.[4]

RA patients with ACPAs or anti-CCP antibodies have a higher risk for joint damage.[3]

Does everyone with gum disease get RA or a flare?


Some scientists did not find a correlation between gum disease and RA, but other scientists have found a significant correlation.

Thus, Porphyromonas gingivalis may cause problems in only some people and some RA patients.

Most plaque arises from a different bacteria

Most plaque on the teeth arises from a different type of bacteria, Streptococcus mutans.

Healthy teeth and gums support your overall health

Many RA patients take one or more medications that suppress their ability to fight infections. The less exposure to disease-causing bacteria or viruses, the better it is for your health.

Regardless, healthy teeth and gums support your overall health. If you’re negative for ACPA or anti-CCP antibodies, it’d be wise to reduce your exposure to agents that may trigger them.

Here are 3 tips for healthy gums.

3 Helpful Lifestyle tips

1. Oil pulling involves vigorous swishing of oil around your mouth and between your teeth for 20mins and then spitting it out. While Ayerveda medicine traditionally recommends sesame oil, several sources recommend coconut oil because of its anti-bacterial, anti-viral and anti-fungal properties. I personally use organic coconut oil. However, I began oil pulling (half a teaspoon) for just 5 min at a time, and then spat it out. Any longer made me feel like gaging.

Sometimes, I’d oil pull again with another half teaspoon of oil. Maybe the oil had dissolved as much gunk from my mouth as it could so I needed to refresh it. Remember to spit it out and rinse your mouth with water afterwards.

Bruce Fife, CN, ND, popularized oil pulling in his book, The New Arthritis Cure: Eliminate Arthritis and Fibromyalgia Pain Permanently.

2. Probiotics for the mouth. Dr. Nan Fuchs recommends opening a capsule of your probiotics and swishing it around your mouth so I tried it.

At first, the gums by a few teeth tingled some but within 10-20 minutes, the feeling was gone. My tongue noticed less plaque within several days, especially at a few hard to reach places. I use the probiotics, Body Biotics.

3. Nutrient dense foods: Gums need sufficient nutrients to maintain the barrier against rough, newly chewed food particles. If your gums are bleeding, consider adding more nutrient dense foods to your diet.

Many people do not consume enough foods with enough trace minerals and omega-3 oils for optimal health.

Eating lots of organic vegetables like organic kale, broccoli, collards, spinach, greens, other brightly colored fruits and vegetables; and wild caught Alaskan salmon, and meats from pasture raised animals can boost your nutrient intake.

Wishing you and your family a rapid healing journey,



Private consultations are available.

Please note: the information on this website is a sharing of information and knowledge from the research and experience of Dr. Molnar-Kimber and her community. It is not intended to replace your one on one relationship with a qualified health care professional. It also is not intended to be medical advice. However, it is often observed that patients who take a major interest in their disease and learn as much as they can about their disease and potential treatments often improve faster than those who don’t. Dr. Molnar-Kimber encourages you to make your own health care decisions based upon your own research and discussions with your qualified health care professional.


1. Mikuls, T.R., et al., Periodontitis and Porphyromonas gingivalis in Patients with Rheumatoid Arthritis. Arthritis and rheumatism, 2014.

2. Mikuls, T.R., et al., Antibody responses to Porphyromonas gingivalis (P. gingivalis) in subjects with rheumatoid arthritis and periodontitis. International immunopharmacology, 2009. 9(1): p. 38-42.

3. Mangat, P., et al., Bacterial and human peptidylarginine deiminases: targets for inhibiting the autoimmune response in rheumatoid arthritis? Arthritis research & therapy, 2010. 12(3): p. 209.

4. Mikuls, T.R., et al., Porphyromonas gingivalis and disease-related autoantibodies in individuals at increased risk of rheumatoid arthritis. Arthritis and rheumatism, 2012. 64(11): p. 3522-30.

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