The Link Between Oral Bacteria and Joint Failure

Joint Failures Potentially Linked to Oral Bacteria

 ScienceDaily (Apr. 18, 2012) — The culprit behind a failed hip or knee replacements might be found in the mouth. DNA testing of bacteria from the fluid that lubricates hip and knee joints had bacteria with the same DNA as the plaque from patients with gum disease and in need of a joint replacement.
This study is one of many that came from the Case Western Reserve University School of Dental Medicine that have linked oral bacteria to health problems when they escape from the mouth and enter the blood. Working with University Hospitals Case Medical Center researchers, the dental, orthopedic and arthritis researchers suggest it might be the reason why aseptic loosening or prosthetic wear of the artificial joints fail within 10 years when no infection appears to be present. The pilot study's findings were reported in the April issue of the Journal of Clinical Rheumatology.
Dr. Nabil Bissada, chair of the Department of Periodontics at the dental school, said the objective of the study, "Identification of Oral Bacterial DNA in Synovial Fluid of Patients with Arthritis with Native and Failed Prosthetic Joints," was to see if bacteria like Fusobacterium nucleatum and Serratia proteamaculans found in patients with gum disease were present in the fluid. "For a long time, we've suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," Bissada says.

The researchers recruited and studied patients seeking care at the University Hospitals Case Medical Center for osteoarthritis (the wearing of the joints) and rheumatoid arthritis (an autoimmune disease). These study participants had both natural and artificial joints. Researcher extracted samples of their synovial fluid, which is much like oil that keeps a door from squeaking. These patients also had signs of periodontitis or gum disease and undergone exams where dental plaque was obtained for the study.

Plaque build-up from the bacteria, associated with gum disease, breaks down the walls of the pockets around the teeth. The inflammation process from the bacteria acts like a gate that gives bacteria access to the blood stream. Once in the blood, the oral bacteria can induce inflammation in remote sites. These oral bacteria have been linked to heart and kidney diseases, and premature births and fetal deaths. Because these bacteria cannot be found with routine lab tests, DNA sequencing analysis of the oral bacteria and the joint fluids are performed. 

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.