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Rheumatoid Arthritis In the Jaw: A Complex Problem

  • Rheumatoid Arthritis In the Jaw
    Rheumatoid Arthritis In the Jaw: A Complex Problem
    • Ann C McCulloch
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    Rheumatoid arthritis in the jaw is more common than people think. The National Institutes of Health reports that the prevalence of temporomandibular disorders (TMDs) is substantially higher in people who suffer from rheumatoid arthritis. They also report that TMJ symptoms and disease severity is increased in people with rheumatoid arthritis. Population studies estimate that more than 50% of people with rheumatoid arthritis also suffer from TMJ issues.

    Here we discuss the characteristics of TMJ rheumatoid arthritis and how to relieve arthritis pain in the jaw.

    Rheumatoid Arthritis In The Jaw

    Rheumatoid arthritis is a chronic inflammatory condition where there is an autoimmune attack against certain tissues in the body. While this autoimmune inflammation can affect many different parts of the body, it notoriously affects the lining of the joints. The intermittent inflammation in rheumatoid arthritis (called “flare ups“) causes swelling and pain in the joints and eventually leads to erosion and deformity, according to the Mayo Clinic.

    There are several distinct clinical characteristics of TMJ disease in people with rheumatoid arthritis, including the following:

    • TMJ tenderness is the most common symptom.
    • Pain or fatigue when eating can be an initial symptom.
    • The jaw joint is usually involved on both sides.
    • Symptoms are intermittent, fluctuating with underlying inflammation.
    • During flare ups, there can be tenderness and swelling of the joint.
    • Early stages of TMJ rheumatoid arthritis may not show up on radiological tests.
    • Rheumatoid arthritis usually affects other joints before the TMJ.
    • Progressive limitation in the jaw range of motion is seen.
    • Crepitation with joint movement (popping, grinding sounds) develops with time.

    There are certain late-stage changes that can be severely debilitating.  These include changes in the bite (malocclusion) and “ankylosis” (stiffening of the joint due to adhesions). Because these changes can result in facial and dental deformities, surgical correction is sometimes required, including TMJ reconstruction.

    Treatment of TMJ Rheumatoid Arthritis

    Rheumatoid arthritis is a complex disease affecting multiple organ systems. For this reason, a whole-body approach to treating rheumatoid arthritis is usually adopted and it’s common for several medical professionals to be involved in the overall care.  “A team approach to rheumatoid arthritis is the norm, with a rheumatologist leading the team. Good coordination of care is one of the best things we can do for rheumatoid arthritis patients”, explains Bradley Eli, DMD, MS, a specialist in orofacial pain and TMJ disorders.

    Using medications to slow the progression of rheumatoid arthritis is a central aspect of treatment. The rheumatologist will typically be the one directing the medication strategy. There are specialized medicines used to fight rheumatoid arthritis, including disease modifying antirheumatic drugs (DMARDs) and other biologic medications.

    For pain, non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be effective for rheumatoid arthritis of the TMJ.

    Rheumatoid Arthritis Jaw Pain Relief

    Aside from medications, there are supportive care measures you can take to help relieve TMJ pain from rheumatoid arthritis, especially during flare ups. These measures include:

    • Jaw exercises: Physical therapy exercises for the jaw can help improve mobility and decrease pain.
    • TMJ diet: A TMJ diet optimized for rheumatoid arthritis will include soft foods, avoid hard foods, and be anti-inflammatory.
    • Hot/Cold therapy: Alternating hot and cold therapy on the joint can help with pain and mobility.
    • Oral Splint Therapy: Anterior bite blocks (such as the Quicksplint) are a type of mouth guard that can be used temporarily to relieve jaw tension and pain.

    The resources listed above are available as part of the Speed2Treat Home Healing Kit. This kit can be invaluable for treating inflammatory flare-ups of TMJ rheumatoid arthritis.  Start your journey towards TMJ pain relief with the Home Healing Kit today!

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    Founder and CEO of Orofacial Therapeutics

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