TMJ jaw pain caused by arthritis of the temporomandibular joint and treatment is discussed by TMJ specialist Dr. James Jacobs of Pacific Oral Surgery. If you have persistent jaw pain or tenderness and/or can’t open and close your jaw completely, it may be a form of arthritis causing this temporomandibular joint disorder (TMJ, TMD).
Types of Arthritis of the Temporomandibular Joint
TMJ Jaw Pain can be caused or worsened by arthritis of the temporomandibular joint. Several types of arthritis can affect the temporomandibular joint, including:
- Rheumatoid arthritis
- Infectious arthritis
- Traumatic arthritis
- Secondary degenerative arthritis
Osteoarthritis is the most common form of arthritis that affects the temporomandibular joint. The jaw joint, as any joint, can degenerate through the everyday wear and tear that occurs as we age. This degenerative process can cause a progressive loss of cartilage within the jaw joint that can eventually result in bone grating on bone.
Temporomandibular joint osteoarthritis is typically characterized by:
- Increased localized pain with jaw use
- Jaw joint tenderness
- Limited range of motion
- Popping/clicking of the jaw
Conservative medical treatments for TMJ caused by osteoarthritis may include:
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as Tylenol
- Limiting movement
- Heat application
- Soft diet
- Bite appliance/mouth guard
If TMJ jaw pain symptoms do not improve with conservative treatment, corrective jaw surgery (orthognathic surgery) may be required.
Temporomandibular Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease that can cause inflammation in the temporomandibular joint.
As RA progresses, it can cause:
- Cartilage destruction
- Bone erosion
- Joint deformity
- TMJ jaw pain
Unlike osteoarthritis (which typically affects patients over the age of 50), rheumatoid arthritis that presents in the jaw joint often affects young children. Over 50% of patients with rheumatoid arthritis report problems involving the jaw joint, with 3 times more women than men being affected.
RA of the temporomandibular joint is characterized by:
- Bilateral jaw pain (both sides)
- Jaw tenderness, swelling, and pain
- Limited jaw movement
- Jaw stiffness
Symptoms of temporomandibular rheumatoid arthritis tend to subside and recur and are often more prevalent upon awakening.
Conservative treatments for RA of the jaw joint include:
- Anti-inflammatory medication
- Disease-modifying anti-rheumatic drugs
- Jaw exercises (to prevent loss of motion)
- Using a mouth guard
Jaw surgery may be recommended if conservative treatments are unsuccessful or if ankylosis (bone fusion in the joint) develops.
Infectious Arthritis in the Temporomandibular Joint
The temporomandibular joint can become infected as a result of an adjacent infection. The infected jaw can present with inflammation, limited movement, and pain. Without proper diagnosis and treatment, permanent jaw damage can occur.
Treatment of TMJ infectious arthritis can involve:
- Pain control
- Restricted movement
- Aspiration (if pus is present or suspected)
- Jaw exercises to prevent scarring
Temporomandibular Disorder from Traumatic Arthritis and Secondary Degenerative Arthritis
In some cases, a traumatic injury can result in arthritis of the temporomandibular joint causing limited motion, pain, and tenderness. Treatment typically involves anti-inflammatory medications, heat application, restricted jaw movement, and softer diet.
Secondary degenerative arthritis (more common in people between the ages 20-40) can develop in patients with myofascial pain syndrome or after an injury.
Symptoms often subside and recur periodically and include:
- Unilateral jaw pain
- Limited jaw movement
- Jaw joint tenderness
- Cracking or grating of the joint (crepitus)
Treatment includes use of an occlusal splint, a mouth guard worn consistently until symptoms resolve, and possibly administering a corticosteroid injection. In severe cases, corrective jaw surgery to replace or reconstruct the joint or to correct condylar enlargement may be necessary.
To arrange a consultation with a doctor at Pacific Oral Surgery, please submit an online appointment request or call one of our Pacific Oral Surgery offices located in Ventura, Thousand Oaks and Simi Valley.
Our team of oral, maxillofacial and dental implant surgeons, Dr. James Jacobs, Dr. John Webb, and Dr. Sebastian Carlson, welcomes you to our Pacific Oral Surgery practice.