Abstract
We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70–3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.
Highlights
Rheumatoid arthritis (RA) is an autoimmune disease that occurs in the elderly, and in younger patients [1]
The general characteristics with respect to age, sex, income, and region of residence were similar between the RA and control groups, due to cross-matching (Table 1), while the other general characteristics like obesity, smoking, drinking alcohol, blood pressure, fasting blood glucose, and total cholesterol varied between groups
The adjusted hazard ratios (HR) for temporomandibular disorder (TMD) in the RA group was 2.52, compared to the control group (Table 2)
Summary
Rheumatoid arthritis (RA) is an autoimmune disease that occurs in the elderly, and in younger patients [1]. RA is one of the most prevalent chronic inflammatory diseases [2] It is a destructive, progressive, and disabling condition affecting over 1% of the world’s population [3]. Pain occurs in 10 to 25% of those affected; fewer than 7% of patients with TMD require treatment [23]. When the TMJ is unable to repair itself, joint degeneration develops [19,26] This could be considered an inflammatory or degenerative disorder, internal joint derangement, and muscular disorder. Greene et al suggested that TMD-related symptoms could be improved with conservative and nonsurgical treatments [27] They suggested that if painful TMD could be treated successfully by conservative and nonsurgical methods, surgical correction of the internal derangement should be avoided [27]
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