Monday, 1 December 2014

Not My Jaw Joint Too!

It's possible for rheumatoid arthritis disease to affect your jaw joint (the TMJ or temporo-mandibular joint). It shows up late; long after the RA starts, in the same way RA affects the cervical spine. 

The TMJ is that joint where your jaw is attached to the upper part of your skull

When I asked my GP doctor about the problem years ago he said there were three courses of action. One was just leave it alone, the second involved taking anti-inflammatories, and the third and worst to me was an injection into the joint. I assume that would have been a cortisone injection. It was a horrifying thought then so I took the "leave it alone" route.

Twelve months ago and a generation later I saw a rheumatology Fellow. He asked about the asymmetry of my face. (News to me!) He and the rheumatologist conferred and sent me for a CT scan. A few weeks later I got a bad news call from my specialist - actually the first call ever. He said that my jaw joint has severe degeneration on one side and moderate degeneration on the other.

So what do you do with that kind of news? I started with my dentist. He gave me a referral to an expert dental surgeon. It practically goes without saying that this surgeon has a waiting list. They told me it would take eight months, but actually by the time I see him a year will have passed.

In the meantime I saw another dentist who used to be a surgeon. He said that my function is better than he would have thought from the scan. Since the jaw joint deteriorates slowly over the years it can adjust to gradual changes and using a night guard for protection would likely be helpful. He also advised me not to eat apples or other large fruits or big sandwiches on hard crusty buns. 

Can't eat this apple no matter what happens

Two RA friends with jaw trouble have had special physiotherapy. Tense muscles contributed to their problems and now they can at least open their mouths wider. Another friend with pain issues was seen recently in group therapy at a pain clinic. Half of the people in her group had jaw problems, so it's a piece of luck that so far I don't see that happening.

My jaw does cause problems. The worst happen after a day in meetings or at a conference. All of that extra stress and extra smiling makes my jaw sore enough to cause pain and headaches. 

You'd think smiling would not put you in the penalty box

TMJ Disorders - NIH

Merck Manuals TMJ

Can orthodontic relapse be blamed on the temporomandibular joint?  Gives some background


  1. Wow, I'm sorry for the bad news, Annette! That's awful! It is a huge worry. Sometimes I take the "no action" route, and I know where my teeth are concerned I'm buying trouble. At the moment though, I literally have no money to invest in them!

    I have had TMJ problems since my twenties. Grinding (anxiety) has been a huge problem. My teeth are worn down. Old fillings have cracked and I currently have a "temporary" stainless steel crown that's been in place for 10 years. It was reglued a couple of years ago. I bite my poor swollen tongue in my sleep a lot, and my jaw "slams" shut even when awake now. I know I should wear a mouthguard. I have headaches almost all the time.

    Thanks as always for highlighting potential trouble spots that no medical professional seems to mention until it's too late.

    I am hoping you can find some relief and a treatment strategy, and that it's not causing you too much pain.


  2. I know what you mean about your tongue Jane. Even with a night guard mine gets bitten through the night. I talked to a dentist at the AAC who suggested the softer mouldable plastic mouth guard as a possibility. I can find out more about that one if it would help.
    In January I see the "Dr. Expert" dentist. He will recommend conservative treatment I'm sure, but at least I will have a fall back if anything more dramatic happens. Amazing sometimes that our dental work holds up at all with Sjogren's.

  3. That sucks that you still bite your tongue with the mouth guard! I've always felt my tongue has been swollen since getting sick. Do you feel the same way. I wonder if there is an inflammation component to it.

    I don't know much about mouth guards, but I like the sound of a mouldable one. That might help me save what's left until I can afford more dental treatment.

    I'll be interested to hear how your visit goes with "Dr Expert". :)