Rheumatoid arthritis

Question 1

Describe rheumatoid arthritis and who it affects mosts

Answer 1

Description:
• Known as inflammation of a joint (localised) or joints (generalised)
• In rheumatoid arthritis, the synovium membrane is inflamed because leukocytes produce inflammatory cytokines. This causes destruction of the cartilage and bone
• Has exacerbations and remissions

Who it affects most:
• More common in women, onset 40- 50 years of age

Question 2

List the general signs and symptoms for rheumatoid arthritis (9)

Answer 2

• Polyarthritis (many joints) with migratory pain, swelling and tenderness
• Warmth in symmetrical joints
• Weakness and fatigue
• Loss of appetite
• Anemia
• Low grade fever
• Progressive deformity with limited motion
• Subcutaneous nodules
• Possible TMJ involvement

Question 3

List the oral signs and symptoms for rheumatoid arthritis (2)

Answer 3

• TMJ involvement/ damage, may cause trismus

* Infections due to medications

Question 4

List the medications used to treat rheumatoid arthritis (5)

Answer 4

• Nonsteroidal anti-inflammatory drugs (NSAIDS)
• Methotrexate
• Gold compounds
• Azathioprine (Imuran)
• Cyclosporin (Sandimmune)

Question 5

Explain the overall dental management for rheumatoid arthritis (3)

Answer 5

• Reduce pressure on mandible
• Provide frequent rest periods due to fatigue in TMJ
• Be wary of oral infections