By Clark Hammock, DMD; doctor, executive vice president, Dentistry of the Carolinas
As if having arthritis isn’t challenging enough on its own, many patients are often shocked to discover it can also rob them of minty-fresh breath. Indeed, if you suffer from arthritis and also bad breath (halitosis), it may be that the two conditions are interrelated.
Can your rheumatoid arthritis medication be causing bad breath?
One simple cause may be the medications you are taking for arthritis pain. Even over-the-counter medications like ibuprofen, naproxen and aspirin can contribute to Sjogren’s syndrome or dry mouth. There are actually over 400 drugs that can affect the salivary glands and a lack of adequate saliva flow can definitely be a factor in causing bad breath. If you are maintaining good oral hygiene but are still experiencing bad breath, be sure to speak to your doctor. A simple change in medication may be all that’s needed.
Studies have shown that people with Rheumatoid Arthritis (RA) may be up to eight times more likely to develop severe periodontal or gum disease (gingivitis) which of course is a major cause of chronic bad breath. Nobody quite understands why and, to be clear, there haven’t been any definitive studies to indicate that RA is a direct cause of periodontal disease. Nevertheless, the statistics bear out. There wasa report in 2006, published in Annals of the Rheumatic Diseases (ARD), that found patients suffering from RA-related wrist problems tended to also suffer from advanced destruction of the periodontium or the tissues that both surround and support the teeth.
So, for RA patients, daily brushing and flossing is critically important. Using a good mouthwash a couple of times a day should also be a part of the regular oral hygiene regimen. However, select your mouthwash carefully. Did you know that some mouthwashes have an alcohol content as high as 21 percent? Alcohol functions as a drying agent and can actually work against you by creating a breeding ground for bacteria. Choose a good fluoride rinse that is alcohol free or at least low-alcohol for the best results. Interestingly enough, there have been studies that show those who had periodontal disease properly treated, and then maintained proper oral hygiene, saw improvement in their Rheumatoid Arthritis.
The No. 1 cause of bad breath is food stuck between teeth or the gums. Those little bits of food provide a smorgasbord for mouth bacteria which produces sulfur or that very unpleasant rotten-egg odor. The best advice is to brush and floss as soon as possible after eating. If that’s just not an option, at least try to swish and rinse with water. The good news is halitosis is usually very curable. Consulting with your doctor and dentist is the best place to start.
DOC’s Dr. Clark Hammock has recently been featured in the Arthritis Services of Charlotte and Mecklenburg County quarterly newsletter. This is the third of four articles addressing oral health and arthritis.