Orofacial pain and dysfunction in patients with rheumatoid arthritis

Method:

21 patients suffering of RA (DAS ≥ 3.2) were investigated for their periodontal condition (pocket depths, clinical attachment level, plaque and bleeding index) and TMJ affections (pain, sound, deviation, limitation). Furthermore, extra- and intraoral masticatory muscles were evaluated for pain at pressure; occlusal relationship, interferences and premature contacts were registered.

Result:

Thirteen patients (62%, mean age 52.61±11.25, 11 women) were diagnosed with moderate to severe forms of chronic periodontitis. There were no significant statistical differences regarding the number, sex, age, oral hygiene status of the patients in both groups (RA group, RA and periodontitis group). 69% of the patients with periodontitis and RA and 62.5% of the RA patients were diagnosed with discal displacement. 52% of the patients exhibited articular pain at the TMJ palpation, the majority being in the periodontitis group (64%); 45% of the periodontitis patients also suffered of muscular pain. Most patients (76.2%) had pain at the intraoral palpation of the masticatory muscles, 11 (52%) also showing pain at the extraoral palpation. Furthermore 62% of the patients (85% with periodontitis) presented TMJ sounds during mouth opening. Interferences or premature contacts were registered in all patients.

Conclusion:

Patients with RA and periodontitis showed significantly more symptoms for orofacial pain and affections of the TMJ as compared to patients suffering only of RA. The early diagnosis and treatment of periodontitis might prevent the development of TMJ dysfunction and orofacial pain.