Dr. James Belcher, December 11, 2025

Periodontitis & Rheumatism – How the mouth puts a strain on your joints

Your mouth is more than just a place to eat and speak – it's a reflection of your overall health. Research shows that inflammation in the mouth, such as periodontitis, can have far-reaching effects on the body. Particularly interesting (and alarming): it can influence joint diseases like rheumatoid arthritis. In this article, you'll learn how gum inflammation is linked to rheumatic conditions – and what you can do to keep your teeth and joints healthy.
Parodontitis & Rheuma – Wie der Mund Deine Gelenke belastet

What's behind it?

Periodontitis is a chronic inflammation of the tooth-supporting structures . It develops when bacteria accumulate in dental plaque and irritate the gums. If left untreated, the jawbone deteriorates, teeth loosen, and in the worst case, are lost. The main culprit: bacteria. Porphyromonas gingivalis , a so-called key pathogen that drives inflammation and alters the bacterial film on the teeth (biofilm).

Why is it relevant?

Periodontitis can exacerbate inflammation throughout the body . P. gingivalis produced Enzymes that are not only local in the mouth , but also throughout the entire body – also in the joints – These substances can cause inflammation (Guo et al., 2025). These pro-inflammatory substances travel through the bloodstream to other parts of the body – including the joints. Studies show that people with rheumatoid arthritis are more likely to have periodontitis , and untreated gum inflammation can worsen rheumatoid arthritis symptoms (Takeuchi-Hatanaka et al., 2021). 


Infobox
Rheumatoid arthritis patients have up to twice the risk of tooth loss if periodontitis remains untreated (De Pablo et al., 2008). 

Scientific background

Researchers found that P. gingivalis among other things It utilizes an enzyme (PPAD) that modifies certain proteins in the body , making them appear foreign to the immune system. This can "confuse" the immune system – the body suddenly attacks its own tissue ( autoimmune reaction ). The result: joint pain, swelling, and flare-ups of rheumatoid arthritis (Bonilla et al., 2024). 

Practical tips for everyday life

  • ✓ Brush your teeth regularly: Twice a day, ideally with a toothpaste that is gentle on the oral microbiome (Chapple et al., 2015).
  • ✓ Clean between teeth: Use dental floss or interdental brushes (Worthington et al., 2019).   
  • ✓ Attend dental check-ups : at least twice a year (Berthelot et al., 2010). 

At a glance

ⓘ Periodontitis can worsen rheumatic inflammation .

ⓘ P. gingivalis It severely disrupts the immune system .

Sources

  • Berthelot JM, Le Goff B. Rheumatoid arthritis and periodontal disease. Joint Bone Spine. 2010;77(6):537–541. doi:10.1016/j.jbspin.2010.04.015.

  • Bonilla M, Martín-Morales N, Gálvez-Rueda R, Raya-Álvarez E, Mesa F. Impact of Protein Citrullination by Periodontal Pathobionts on Oral and Systemic Health: A Systematic Review of Preclinical and Clinical Studies. Journal of Clinical Medicine. 2024;13(22):6831. doi:10.3390/jcm13226831.

  • Chapple IL, Van der Weijden F, Doerfer C, et al. Primary Prevention of Periodontitis: Managing Gingivitis. Journal of Clinical Periodontology. 2015;42 Suppl 16:S71–S76. doi:10.1111/jcpe.12366.

  • Eick S, Taudte N, Ramsbeck D, Magdon A, Sculean A, Potempa J, Buchholz M. Effect of a bacterial glutaminyl cyclase inhibitor on multi-species biofilms. Frontiers in Oral Health. 2025. doi:10.3389/froh.2025.1716625.

  • Guo X, Wang S, Ding J, et al. Periodontopathic Bacteria in Rheumatoid Arthritis Pathogenesis: Bridging Clinical Associations to Molecular Mechanisms. Frontiers in Immunology. 2025;16:1681037. doi:10.3389/fimmu.2025.1681037.

  • de Pablo P, Dietrich T, McAlindon TE. Association of Periodontal Disease and Tooth Loss With Rheumatoid Arthritis in the US Population. The Journal of Rheumatology. 2008;35(1):70–76. doi:10.3899/jrheum.071010.

  • Takeuchi-Hatanaka K, Koyama Y, Okamoto K, et al. Treatment Resistance of Rheumatoid Arthritis Relates to Infection of Periodontal Pathogenic Bacteria: A Case-Control Cross-Sectional Study. Scientific Reports. 2022;12(1):12353. doi:10.1038/s41598-022-16279-z.

  • Worthington HV, MacDonald L, Poklepovic Pericic T, et al. Home Use of Interdental Cleaning Devices, in Addition to Toothbrushing, for Preventing and Controlling Periodontal Diseases and Dental Caries. The Cochrane Database of Systematic Reviews. 2019;4:CD012018. doi:10.1002/14651858.CD012018.pub2.

Back to the Knowledge Magazine

Daily care for healthy gums

PerioTrap® Microbiome Toothpaste: Gentle, selective and designed for strong teeth and a balanced microbiome – for every day care.

Learn more and buy

Made in Germany