What to know about psoriatic arthritis jaw pain

From medicalnewstoday.com

Psoriatic arthritis can affect any joint in the body, including the jaw. The condition can cause jaw pain, teeth grinding, and other dental issues such as tooth loss.

Psoriatic arthritis (PsA) is an autoimmune condition. It causes joint pain, swelling, and stiffness.
PsA causes inflammation that attacks healthy joints and tissue, leading to painful symptoms.
In this article, we look at how PsA can affect the jaw. This includes jaw-related symptoms, complications, treatments, and how to relieve jaw pain.

PsA and jaw pain

PsA can affect the temporomandibular joint (TMJ), or jaw joint, in the same way as other joints in the body.
Recent research suggests that jaw pain may affect up to 35 percent of people who have PsA.
One study states that psoriasis and PsA play a significant role in TMJ disorders. These TMJ problems can include:

• clicking or making other sounds when using the jaw
• pain when moving the jaw
• misalignment of the jaw
• teeth grinding, or bruxism

People who have jaw pain from PsA may experience symptoms that make it difficult to chew, eat, drink, speak, and sleep.
Many current treatments can help control inflammation and the immune system's involvement, allowing many people with PsA to lead active lives and stay healthy.

Can PsA cause dental problems?

PsA mainly affects the joints, but it appears to have a link to gum disease and dental problems, too.
One 2013 study found that people with PsA had more severe gum problems than those who did not have the condition. Gum disease can lead to chronic bad breath, changes in bite, and, in severe cases, tooth loss.
A more recent study suggests that the inflammation in PsA could lead to gum inflammation. However, researchers need to explore this further to fully understand the link.
People with PsA have a higher rate of TMJ problems, which can lead to tooth damage from grinding and clenching. A dentist may prescribe a bite splint that a person can wear over the teeth to protect them from damage.

Home remedies for PsA and jaw pain

There are some home remedies that can help relieve jaw pain, clicking, grinding, and any other symptoms that affect the jaw.
Medical treatments can tackle the underlying causes of PsA symptoms to prevent joint damage and stop the condition from progressing.
People should not rely on home remedies alone to treat PsA, however. This is because even if symptoms are mild, the condition can still cause permanent damage to the joints.
To relieve PsA-related jaw pain at home:

Apply ice or heat

Many people find that applying a moist heat pack is effective for relieving jaw pain and stiffness. Ice packs can also soothe pain and reduce swelling and inflammation. However, avoid leaving an ice pack on for more than 10 minutes at a time.

Adopt a jaw-friendly diet

People with PsA that affects the jaw may wish to temporarily switch to a jaw-friendly diet when their symptoms flare up.
A jaw-friendly diet includes foods that are soft or liquefied to give the jaw a chance to rest and heal.
Tips for adopting a jaw-friendly diet include:

• avoiding chewy and crunchy foods, such as crusty breads, chips, and chewy meats
• opting for cooked instead of raw vegetables and fruits
• making smoothies with fresh vegetables and fruits
• eating soups

Rest the jaw

A jaw that is inflamed from PsA may be less painful when a person gives it time to rest. Some ways to rest the jaw include:

• avoiding chewing gum
• being mindful of chewing habits, such as biting the nails or chewing on pens, that can stress the jaw
• taking time away from activities that require extensive talking, such as lectures and meetings
• avoiding cradling a phone between the face and shoulder, as this can stress the neck and jaw muscles

Reduce stress

High stress levels can cause a person to grind their teeth and clench their jaw more often. Using relaxation techniques such as meditation, yoga, and deep breathing can help reduce tension in the jaw.
Reducing stress can also help with other PsA symptoms, as stress can cause psoriasis and PsA flares.

Seek physical therapy

Practicing specific exercises, with the guidance of a physical therapist, can help relieve PsA symptoms in the jaw and other joints.
Research has found that physical therapy can help with TMJ symptoms and jaw joint pain.
Physical therapy for the jaw may involve jaw movements, stretches, and correcting the positions of the body and head.

Exercise

Physical activity can help reduce stress and improve sleep. The National Psoriasis Foundation recommend exercise as a way to relieve PsA symptoms. Regular exercise keeps the joints and tendons loose and reduces inflammation.

Treatments

Inflammation and an overactive immune response cause most PsA symptoms, including those in the jaw.
Because of this, doctors will usually treat PsA-related jaw pain by reducing one or both of these.
Below are some treatment options for PsA, including jaw-related symptoms:

• Take nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, aspirin, and naproxen, for temporary pain and inflammation relief. Ask a doctor before taking NSAIDs for prolonged periods of time.
• Ask a doctor about corticosteroid injections, which can quickly reduce swelling and pain. A clinician will usually administer these in-office.
• Take prescription inflammation medicine. Some newer oral medicines, such as tofacitinib and apremilast, can help control inflammation that causes PsA.
• Take disease-modifying anti-rheumatic drugs, which prevent inflammation-causing chemicals that result in the clinical findings seen in PsA.
• Ask a doctor about biologics. Scientists make these agents from living cells in a laboratory. A person takes biologics by injection or infusion. These drugs target certain cells or proteins in the immune system that cause PsA.

Diagnosis

There is no single test for PsA or TMJ problems. However, a clinician will use a combination of medical tests, a person's medical history, and a physical exam to determine whether a person has PsA and which joints may be affected.
Diagnostic tests for PsA and jaw involvement may include:

• blood tests, which can help rule out other types of arthritis, such as rheumatoid arthritis
• X-rays of the jaw and other joints, though these do not usually detect early-stage PsA
• MRI scans
• a skin exam to look for rash or silvery scales, which are signs of psoriasis
• a physical exam of the jaw
• medical history and family history, because PsA can be genetic

Other symptoms of PsA

PsA is related to psoriasis, a skin condition that causes a scaly rash. About 30 percent of people who have psoriasis also develop PsA. As a result, many clinicians will check for PsA when a person experiences psoriasis and joint pain together.

However, doctors cannot always diagnose PsA based on skin symptoms alone. Some people develop PsA without having psoriasis. In 85 percent of people with PsA, the skin symptoms come before the joint symptoms.
PsA is different from other forms of arthritis. Many types of arthritis can cause joint pain and stiffness, but PsA has its own unique symptoms.
Studies show that two particular symptoms can be tell-tale signs of PsA: enthesitis and dactylitis.

Enthesitis

Enthesitis is inflammation in areas where tendons or ligaments attach to bones. This can cause new bone to form, similar to a bone spur.
It can also cause pain, stiffness, and swelling. Enthesitis often affects the heels, bottoms of the feet, fingertips, elbows, knees, hips, and the spine.
The pain from enthesitis may be focused on an area next to the joint rather than the joint itself.

Dactylitis

Dactylitis causes swelling, inflammation, and pain in an entire digit (finger or toe). This symptom can cause severe pain and may make it difficult or impossible to move the affected digits.
Dactylitis normally affects one or a few digits, but not in a symmetrical pattern. This means that it can affect one side of the body and not the other.

Other signs

Other signs of PsA include:

• spondylitis, wherein PsA affects the joints in the spine, pelvis, or neck
• fatigue
• joint stiffness, especially in the morning
• pain, throbbing, and stiffness in one or more joints
• nail changes, such as crumbling, pitting, or a nail fungal infection
• uveitis, which is inflammation within the eye that causes redness and pain, affects about 7 percent of people with PsA

Outlook

PsA symptoms, including those that affect the jaw, can be painful and disruptive to a person's daily life. However, following an effective treatment plan for PsA can help a person get relief and, in many cases, achieve remission.
The Arthritis Foundation say that up to 60 percent of people with PsA can achieve remission with proper treatment. Remission means that there is very little disease activity in the body. However, it does not mean that a condition is cured, or that a person can stop taking their medications.
People with PsA must take their medications indefinitely, as their doctor prescribes, to keep their condition under control and achieve the best possible quality of life.

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