When I was first diagnosed with psoriatic arthritis, I put all of my focus on my disease. I sought information about my condition nonstop, tried everything to feel better, and attended doctor appointments frequently. With my disease at the forefront of my mind, I neglected my dental health. Like most preteens, I had braces in middle school. My family paid thousands of dollars so I could have straight, white, shiny teeth. Unlike most kids who get braces, I cared for my teeth, brushing twice daily and flossing between my brackets. I never had a cavity in any of my adult teeth because I respected my parents’ hard work, so when I sat in a new dental office after moving and not going to a 6-month cleaning, I was told I had ten cavities. I cried in shock and fear. I was disgusted with myself. How could I go from having a clean mouth to having so many cavities?
My dentist did not bother to talk to me about potential reasons for this. Although it had been a while since I went to the dentist, I still cared for my teeth like always. My dentist shrugged and told me it must be due to sugary drinks. I tried to protest his accusations, but telling him I didn’t drink soda while he was drilling into my teeth was difficult. They filled and drilled my problem teeth, and I left with my wallet emptier and my self-esteem lower. After my impersonal visit to the dentist, I switched to a different dentist. If you do not like a health provider, you can shop around. You deserve to be treated respectfully, and I knew I needed to change providers.
My new dentist was Dr. Andrea Wallace at Wallace Family Dentistry. My consultation with Dr. Wallace comforted me in ways I couldn’t imagine. I was overjoyed that I put myself first and found a new provider. Wallace examined my previous X-rays and confirmed I had more cavities since my recent fillings. I felt like breaking down, but I got the courage to ask her why this was happening to me. We discussed my overall health issues, and she informed me that new research found a link between autoimmune diseases and decay. She told me that my teeth were clear with little to no plaque, making my cavities a mystery rather than my fault. She also gave me some new dental hygiene products with nano-silver. I scheduled my next filling appointment with faith that I was in the right hands.
Curiosity got the best of me, and I began reading research articles about my condition. While there are few resources, a few points are widely understood. The two problems have a definite link and are not a one-way street. Autoimmune diseases may cause dental issues, and dental problems can create autoinflammatory responses. The most known link is how autoimmune diseases or medications patients take cause dry mouth. Saliva covers and remineralizes teeth, so the teeth can break down when there is not enough saliva in the mouth. It is hard to keep up with dry mouth with lounges, sprays, and other products because they are not accessible most of the time. My job requires me to talk constantly, and while I drink water throughout the day, it isn’t enough to combat the dryness from my medication, methotrexate. Some researchers believe that people with specific conditions have more acidic saliva, causing quicker decay, too. Collagen is another factor to consider. Various connective tissue diseases such as lupus, rheumatoid arthritis, and scleroderma cause inflammation in collagen. Collagen is essential because it makes up the fibers in teeth and bones.
In addition to the previous research, a breakthrough study revealed a link between autoimmune diseases and a tooth enamel defect. The study found “that most patients with APS-1 and celiac disease develop autoantibodies, especially of the IgA isotype, against proteins specific to ameloblasts. As a consequence, the body’s tolerance to these proteins is disturbed, leading to impaired enamel formation.” (Breakthrough Study Reveals Link between Autoimmune Disorders and Tooth Enamel Defects – Institute of Molecular Genetics of the Czech Academy of Sciences) APS-1 refers to the autoimmune polyglandular syndrome. My enamel has been fading, causing noticeable white spots on my teeth. This discovery could lead to the answer I have been seeking, but only time will tell as researchers continue to study this phenomenon with other patients and autoimmune diseases.
Even though I know that every dental visit will result in more cavities, I am now more educated about my situation. Cavities can be produced for other reasons than poor hygiene, and while I will continue to brush and floss daily, I refuse to obsess over my teeth’s flaws because it has simply been proven to be not my fault. I hope that in the future, more research will be conducted to help patients like me with their dental health because although insurance doesn’t consider it a part of your overall health, dental health is critical.
