Rheumatoid Arthritis in the Jaw: What to Know

Rheumatoid arthritis (RA) is an inflammatory condition that occurs when your body's immune system mistakenly attacks its own cells. RA commonly affects joints throughout the body, including the jaw. Rheumatoid arthritis causes inflammation, which leads to redness, swelling, pain, warmth, and stiffness in the affected areas.

This article discusses RA in the jaw, including symptoms, diagnosis, and treatment.

Symptoms of RA in the Jaw

Chances are, you haven't paid much attention to your jaw joint. But, when it's inflamed—as occurs with rheumatoid arthritis—it's almost impossible to ignore. Your jaw moves frequently throughout the day as you talk, eat, and swallow.

Your jaw joint, called the temporomandibular joint (TMJ) can be felt a few finger-widths in front of your ear on each side of your face. This joint is formed by your lower jaw (mandible) and your skull. An articular disk provides padding between these bones, and ligaments that attach bone to bone provide additional support. Many muscles surround the area to move your TMJ.

Symptoms of RA in the jaw can include:

• Pain at the TMJ
• "Locking" of your jaw in one position
• Scraping sensation in the joint
• Clicking or clunking with jaw movement
• Jaw stiffness
• Difficulty chewing hard foods
• Changes in the way your teeth are aligned
• Sore muscles in your cheeks
• Swelling at the TMJ

These symptoms are also common with other conditions that affect the TMJ. However, one of the hallmark signs of RA is that it affects joints on both sides of the body at the same time. Other conditions that cause jaw issues usually only affect one side of your jaw.

RA in the jaw can also cause other symptoms, such as TMJ headaches, earaches, and ringing or buzzing sounds in your ears.

How Is RA in the Jaw Diagnosed?

Diagnosing RA begins with your healthcare provider collecting information about your symptoms. Rheumatoid arthritis affects your whole body—not just the jaw. Early on, symptoms of RA usually appear in the hands, fingers, and wrists.

Symptoms

Symptom criteria for diagnosing RA typically include:

• Pain, swelling, and stiffness in your joints lasting more than six weeks
• Joint stiffness in the morning
• Symptoms on both sides of the body
• Bumps under the skin near joints (called nodules)
• Symptoms in your hands, wrists, and fingers

Blood Work

Blood work is important in the diagnosis of RA. General blood tests offer information about levels of inflammation in the body.

Other specific blood tests look for the presence of rheumatoid factor (a specific antibody that occurs with inflammatory conditions), anti-cyclic citrullinated peptide (CCP), erythrocyte sedimentation rate (ESR or sed rate), and C-reactive protein (CRP) in the blood.

Imaging

As your condition progresses, imaging is useful in determining how much damage RA has caused to a specific joint, such as your jaw. X-rays are often the first step in imaging an inflamed joint. This image provides information about the bones in your joint, how they are aligned, and whether there has been joint damage (erosive disease).

Magnetic resonance imaging (MRI) is most often used to assess soft tissues in your joints, such as the articular disk in your TMJ. Computed tomography (CT) can be used to further assess the damage that RA has done to the bones of your jaw.

Treating Jaw Pain from RA

Jaw pain from RA can be treated with medications and home remedies.

Medications

Rheumatoid arthritis is treated with medications that target your overactive immune system to decrease inflammation throughout the body. These medications—called disease-modifying antirheumatic drugs, or DMARDs—can help decrease pain in your jaw and other joints in your body. However, they can take months to start working.

Anti-inflammatory medications are commonly used to treat jaw pain from RA. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen) and Advil (ibuprofen) help reduce swelling and jaw pain. If these aren't effective, your healthcare provider might prescribe a steroid medication, such as prednisone.

Home Remedies

Jaw pain can also be treated with home remedies, such as:

• Use ice or heat: Either heat or ice can be applied to the sensitive area for 10–20 minutes at a time, multiple times a day, depending on the underlying cause of pain. Ice can help reduce swelling and pain, while heat can increase blood flow and relax the muscles 
• Relax your jaw: Don't clench your teeth as clenching puts a significant amount of pressure on your inflamed TMJs.
• Eat soft foods: Avoid hard or chewy foods during a flare-up. This includes hard candies and chewing gum.
• Limit movement: Use smaller jaw movements when you are eating, talking, and yawning. Opening your jaw all the way increases pressure on your TMJs.
• Massage sore muscles: Gently massage the muscles of your cheeks and temples with your fingertips for several minutes.
• Use a mouth guard: Consider wearing a mouth guard when you sleep to reduce pressure on your jaw joints—especially if you grind or clench your teeth.
• Keep hands off: Avoid resting your chin in your hands when you have jaw pain.

Summary

Rheumatoid arthritis is a chronic inflammatory condition that occurs when the body's immune system attacks its own cells. RA often targets joints throughout the body, including the jaw. Symptoms of RA in the jaw include pain, stiffness, clicking, and limited movement. Treatment includes anti-inflammatory medications and home remedies.

A Word From Verywell

Living with rheumatoid arthritis can be challenging, particularly during a flare-up. Jaw pain can be especially frustrating, but simple changes to your habits can make a big difference. Follow your healthcare provider's instructions regarding medication and lifestyle changes to help keep your inflammation in check, and be sure to let them know when something isn't working. Consider joining a support group for additional support and tips.