Impact of Temporomandibular Joint Pain in Rheumatoid Arthritis

Neveen Ahmed,Anca Irinel Catrina,Per Alstergren,Hamid Masoud Mustafa

doi:10.1155/2013/597419

Abstract

To investigate the impact of temporomandibular joint (TMJ) pain on daily activities and quality of life in relation to systemic inflammatory activity in patients with rheumatoid arthritis (RA), thirty-three consecutive outpatients with RA were included. TMJ pain intensity at rest, on maximum mouth opening, and on chewing was assessed on a 0–10 numerical rating scale. TMJ palpatory tenderness, degree of anterior open bite, the impact of TMJ pain on daily activities and quality of life were also assessed. The systemic inflammatory activity was estimated by the disease activity score 28 (DAS28), blood levels of inflammatory markers and number of painful musculoskeletal regions. TMJ pain at rest, on maximum mouth opening, and on chewing as well as DAS28 was correlated with the impact of the TMJ pain on daily activities and quality of life. Partial correlations showed a significant interaction between TMJ pain on movement and DAS28 that explained the TMJ pain impact on daily activities and quality of life to a significant degree. This study indicates that both current TMJ pain intensity and systemic inflammatory activity play roles in the impact of TMJ pain on daily living and quality of life in RA.

Highlights

Pain is the major factor that reduces the quality of life for patients with rheumatoid arthritis (RA) [1]; for example, 66% of RA patients graded pain as the most important problem [2]
This study indicates that both current temporomandibular joint (TMJ) pain intensity and systemic inflammatory activity are interactive factors behind the impact of TMJ pain on daily living and quality of life in RA
This implicates that TMJ treatment planning and prognosis estimation in RA patients should consider the TMJ pain intensity and the systemic inflammatory activity

Summary

Introduction

Pain is the major factor that reduces the quality of life for patients with rheumatoid arthritis (RA) [1]; for example, 66% of RA patients graded pain as the most important problem [2]. Pain is considered as the main reason for those patients to seek treatment [2]. The temporomandibular joint (TMJ) is often and early affected by RA [3]. For example Aliko and coworkers [4] found that 65% of RA patients have TMJ symptoms. The most common clinical finding is TMJ pain, especially on movement or loading. Involvement of the TMJ by RA may, besides pain, cause limitations of jaw function due to restriction of condylar translation. An anterior opening of the bite due to articular cartilage and bone tissue destruction may develop [5]

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Conclusion