Are you wondering about Rheumatoid Arthritis and TMJ? Tigard Dentist Dr. Justin Marostica recently had an experience where TMJ (tempro-mandibular joint) pain was found to be Rheumatoid Arthritis. The temporomandibular joint (TMJ) is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. Rheumatoid arthritis is a chronic autoimmune disorder that causes inflammatory destruction of the joints. Through constant and regular evaluations by a dentist or primary care physician the symptoms of Rheumatoid arthritis can be detected.
Rheumatoid arthritis affects 3% of people in the United States and approximately 200,000 new cases are diagnosed yearly. The TMJ will eventually become involved in 75% of patients, although the involvement is usually so mild that it can go unnoticed . Interestingly Rheumatoid arthritis affects women three times more frequently than men. The onset and course of the disease can be extremely variable. For most people, only one or two joints become involved, and significant pain or limitation of motion never develops.
Typically, the signs and symptoms become more severe over time and include swelling, stiffness, pain, joint deformity, and disability. There can be periods of remission that are often followed by periods of exacerbation. Symmetric involvement of the small joints of the hands and feet almost always is present, but it is not unusual for knees and elbows to be affected. The hip joint just happens to be the joint least affected by Rheumatoid arthritis.
The TMJ is affected to some degree in more than 40% of persons with rheumatoid arthritis. When present, TMJ involvement is usually bilateral and occurs late in the disease. The signs and symptoms are seldom as severe as in other joints and include stiffness, cracking noise in the joint, pain or ache, tenderness, or limitation of mouth opening. Swelling is less obvious than with other joints. Frequently, the pain of TMJ rheumatoid arthritis is not related to the motion of the joint but rather to pressure on the joint. Clenching the teeth on one side produces pain of the opposite joint.
No cure exists for rheumatoid arthritis, and current treatments strive only to suppress the process as much as possible. Drug therapy in early and mild cases consists of nonsteroidal antiinflammatory drugs (NSAIDS), perhaps aided by occasional corticosteroid injections into the joint. If the TMJ joint or any other joint for that matter becomes severely damaged, joints may have to be replaced surgically.
If you or anyone you know suffers from any of the symptoms of rheumatoid arthritis don’t hesitate to speak with your primary care doctor. If you have constant pain in your TMJ speak to your dentist or doctor about possible treatments and causes.
Post written by Dr. Justin Marostica of Tigard TenderCare Dental