Arthritis and Jaw Pain

Is there a connection between arthritis and jaw pain? The short answer: Yes, in a number of cases. Here is a more complete answer.

Arthritishuman jaw model - paid - Depositphotos 11130577 m-2015

There are more than 100 types of arthritis and related rheumatic diseases. A list of those can be found here: https://www.arthritis.org/about-arthritis/types/. Each type of arthritis has a unique characteristic in terms of its cause and its pattern.

The most common type of arthritis is osteoarthritis. This is the “wear and tear” form that degrades some joints through overuse. Because it is caused by overuse, it typically manifests as we age.

Other types of arthritis (including rheumatoid arthritis and psoriatic arthritis) are caused by an autoimmune defect that causes the immune system to attack healthy joints by mistake. When this happens, the joint tissues become inflamed, swollen, twisted, and painful. Arthritis can affect any joint in the body. The autoimmune forms can also affect other types of tissues.

The Human Jaw

The jaw is composed of several complex joints. The movement of the joints is assisted by muscles, bones and soft tissues. The temporomandibular joint (TMJ) and others are used consistently in eating, speaking, yawning, swallowing and some facial movements and expressions. Many people grind their teeth either when awake or when asleep (or both). Grinding puts a great deal of stress on these joints that are frequently used.

When a form of arthritis attacks or invades the joints of the jaw, particularly the temporomandibular joint, it typically causes inflammation, swelling, distortion and pain. More severe cases of arthritis affecting the joint can also limit joint movement and/or the ability to open one’s mouth and keep it open for any time.

How Arthritis Affects the Jaw

A large number of people with rheumatoid arthritis also have TMJ problems and experience jaw pain. One study estimated that as many as 90% of rheumatoid arthritis patients also have TMD. It seems that the effects of rheumatoid arthritis on the joints in the hands is a good indication of TMD severity.

Both rheumatoid arthritis and TMJ are more common in women: about three times as many women than men have rheumatoid arthritis.

Psoriatic arthritis can also affect the jaw. It also causes pain, swelling, stiffness. It has also been shown to be a cause of teeth grinding and a range of other dental issues, including tooth loss. A recent study found that as many as 35% of people who have psoriatic arthritis also have jaw pain.

Arthritis affects the jaw by causing narrowing in the joint space, joint and bone erosion, bone deformity, and eventually complete disappearance of joint space. In addition to pain, the jaw may make cracking, crunching, or grinding sounds. The ability to open one’s mouth may become limited.

Treatment

Physiotherapy has been of no long-term benefit according to repeated studies. The effects of arthritis upon the jaw are treated in much the same way as other joints. Initial treatment with NSAIDS (non-steroidal anti-inflammatory drugs), application of heat, and steroids is typical. These drugs help to reduce pain and inflammation. The second tier of medications are typically DMARDS (disease-modifying anti-rheumatic drugs) which promote remission of the disease and prevention of additional damage to affected joints. In some cases, pain can be relieved by injecting local anesthetics and sometimes arthroscopic surgery.

The best test for damage due to arthritis is the CBCT, a relatively new approach to imaging. This type of imaging detects early effects of arthritis upon the jaw more accurately than traditional X-rays.

What You Can Do

Arthritis in the jaw is painful. As the disease progresses, movement may become limited. The jaw is essential in speaking and eating. There are some things you can do to complement your doctor’s or dentist’s treatment. These include:

  • Change your diet to include more soft foods that are easier to chew.
  • Avoid chewy candy and chewing gum.
  • Avoid opening your mouth any wider than absolutely necessary when eating, talking or yawning.
  • Apply ice or heat to your jaw area. Try both ice and heat to discover which treatment is most effective for you. If you find heat to be most effective, moist heat will be most effective.
  • Mouth guards can be custom designed and fitted by your dentist, or braces can be used, to hold your jaw in the optimal position. These devices often need to be used for only a few hours per day. Your dentist will explain how and when you can derive the greatest benefit from these devices.
  • Ask your doctor and dentist about possible benefits of acupuncture. Your doctor or dentist can refer you to a good acupuncturist. Some people find this particularly effective.
  • Take medications prescribed by your rheumatologist or dentist regularly and as prescribed.
  • Know what kind of side effects of your medications could affect your mouth. Some of the medications can make you more susceptible to infections (Candida or Thrush), some (e.g., Methotrexate) can cause mouth ulcers. These can often be treated with folic acid. Discuss any reactions or infections with your doctor immediately.

Conclusion

Rheumatoid arthritis and Psoriatic arthritis are two forms of the disease that often affect the jaw. Early diagnosis and treatment can assist in pain management and in reducing inflammation. If you have arthritis and you have pain, popping sounds, or other crunching or grinding sounds when you move your jaw, it is wise to see your dentist and your rheumatologist immediately. Prompt treatment is key to controlling the effects of arthritis on the jaw and relieving pain.

Some rheumatologists and some dentists may work together to treat your jaw pain. The goal of all treatment is to reduce your pain and limit the future damage the arthritis may cause. At Complete Dental Care in Salem VA, Dr Wallace is eager to work with your rheumatologist to coordinate your treatment.