What to Do About RA Jaw Painby Sarah Ellis Health Writer
About 17% of people living with rheumatoid arthritis (RA) or juvenile idiopathic arthritis (JIA) say it affects their jaw, making it difficult to eat and even speak. All RA warriors know how frustrating flares can be, especially when they disrupt your day-to-day life. But if your chronic condition gets in the way of letting you enjoy a delicious meal? That’s the definition of adding insult to injury. Here’s what to know about the connection between RA and jaw pain, and how to find some sweet, sweet relief.
Where Is the TMJ?
The medical term for your jaw joint is the temporal mandibular joint (TMJ). “To get a sense of where it is located, place your index finger just inside your ear, palm facing forward,” says William Harvey, M.D., clinical director of rheumatology at Tufts Medical Center in Boston. (Your fingertip should cover the opening to the ear canal.) “You can feel the TMJ move with your finger if you open and close your mouth.” Several conditions can cause TMJ dysfunction, including an injury, teeth grinding, connective tissue diseases… and yes, RA.
Who’s Most at Risk?
RA is a body-wide disease, and any joint is fair game. In adults with RA, those with untreated symptoms are at highest risk for jaw pain. “People with untreated or undertreated RA are at risk,” Dr. Harvey explains. “People with RA who have a prior history of problems like jaw fracture or dislocation may be at higher risk.” A 2017 study in the European Journal of Rheumatology noted that the more severe and long-term your RA symptoms are, the more likely you are to feel jaw pain when you experience a flare.
TMJ in Kids
Fardina Malik, M.D., a rheumatologist at NYU Langone in New York City, explains that TMJ pain often shows up in children with JIA, the most common type of inflammatory arthritis for kids and teens. More than half of children with JIA have jaw involvement, according to the Arthritis Foundation (the reason is unclear). “The consequences of the involvement of the jaw in children is significantly different than consequences when it affects an adult,” Dr. Malik explains. For children, this can result in facial growth problems over time, so it’s important to see a rheumatologist ASAP.
Early Signs of RA Jaw Pain
“Early symptoms are pain in or in front of the ear while chewing, clicking, or locking of the jaw, or a grating [or] grinding sensation in the jaw while opening and closing the mouth,” Dr. Harvey says. These symptoms are often worse in the mornings and happen alongside RA flares in other joints. “With just a little bit of chewing movement, they will feel tiredness or pain in the muscles around [the jaw],” she says. You may be unable to close your upper and lower teeth together normally.
More Advanced Signs
If your disease progresses for years without clinical intervention, you’ll likely notice your jaw pain getting worse and more frequent. This may correlate with increased pain in other joints like the fingers, wrists, and feet. In severe cases, Dr. Harvey notes, TMJ swelling could cause dislocation of the jaw, which would require the immediate attention of an E.R. doctor to make sure you can eat and breathe properly, followed by an appointment with your rheumatologist to get your inflammation in check.
Ruling Out Other Conditions
It’s possible that your jaw pain could be related to some other health issue, which would affect the treatment plan you’d want to pursue. “We have to understand, is it really due to RA, or is it due to another condition?,” Dr. Malik posits. If your RA is well-controlled and it’s only your jaw that’s bothering you, you may have another TMJ disorder related to genetics or lifestyle habits—like clenching your teeth throughout the day. Talk with your doctor if you need help figuring this out.
At-Home Relief for Jaw Pain Flares
Dr. Malik notes that applying heat (like heat pads or a hot shower) or cold (like an ice pack) can reduce pain and inflammation during a flare. You can also try an OTC medication like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)—as long as your doctor has given the green light. “Selecting foods that are not overly chewy or can be cut into small pieces often removes the repetitive motion of chewing that leads to pain,” Dr. Harvey says. If your jaw hurts at night, talk with your dentist about getting a mouth guard to help you sleep.
Longer-Term Treatments for RA Jaw Pain
Treatment for RA-related jaw pain mirrors treatment for any other symptom of RA. Your rheumatologist may prescribe DMARDs, a category of drugs designed to slow RA progression. “There’s physical therapy for patients with jaw pain,” Dr. Malik says. “Some people do get intra-articular steroid injections” when their pain is particularly severe, and these would be performed by an oral surgeon. “The most important thing, however, is not to delay care to the point where the damage gets to that point [that it’s irreversible],” Dr. Harvey says. Hopefully, you won’t need an intervention this severe.