Osteoarthritis (OA). Also known as degenerative joint disease (DJD)



Rheumatoid arthritis of hands


Arthritis is a condition in which one or more of the joints in your body become inflamed to cause soreness, stiffness and sometimes swelling. There are dozens of types of arthritis but generally speaking, there are two major categories of arthritis…….inflammatory and non inflammatory. An example of inflammatory arthritis is rheumatoid arthritis (RA) in which the immune system attacks the soft tissues in a joint (a type of autoimmune disease). An example of non inflammatory arthritis is osteoarthritis (OA), also known as degenerative joint disease (DJD), or “wear and tear” arthritis. It is possible to have both osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA) occurs when the cartilage in a joint breaks down over time. Cartilage is a resilient tissue that covers the ends of bones that meet in a joint. It serves as a shock absorber, like the shock absorber in a car. When the cartilage is gone, there is bone on bone contact and this results in pain and loss of mobility…..and inflammation, even though OA is considered a non inflammatory arthritis. OA usually occurs in the knees, hips, spine and hands. Initial treatment for OA includes weight loss, exercise and over the counter nonsteroidal anti-inflammatory medicines (NSAIDS) such as ibuprofen (Advil, Motrin etc) and naproxen sodium (Aleve etc). Opioid pain killers may be prescribed but they run the risk of addiction over a period of time. If the OA does not respond to conservative treatment, surgical intervention may be necessary to fuse the bones in the joint or prosthetic joint replacement.

Rheumatoid arthritis (RA) is considered an autoimmune disease where the immune system attacks normal tissues in a joint. RA is more of a systemic condition whereas the symptoms of OA are usually limited to a single joint. . Since RA is a systemic inflammatory condition it can also cause weakness and fatigue. RA can result in deformities of joints. RA usually affects smaller joints like hands, wrists, elbows, ankles, knees and feet. There is a blood test for RA called rheumatoid factor but it is not 100% diagnostic because it can have false negatives. Treatments include: corticosteroids (prednisone etc), NSAIDS, opioid pain killers, disease modifying antirheumatic drugs (DMARDs)(methotrexate,Trexall,Rasuvo and hydroxychloroquine/Plaquenil) ….biologics  (Enbrel, Erelzi, Eticovo,Remicade) and JAK inhibitors.  DMARDs target the entire immune system, whereas biologics work by targeting specific steps in the inflammatory process outside the cells (cytokines), and JAK inhibitors block enzymes (JAK1,JAK2, JAK3) inside the cells.

At Britt Perio we have effective methods to reduce the periodontal inflammatory burden on the body which will have a positive effect on managing arthritis.