Psoriatic arthritis can affect any joint in the body, including the jaw. It can lead to jaw pain and stiffness and problems with eating and speaking. Home remedies and medical treatment can help.

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. While rare, it can affect the temporomandibular joint (TMJ), leading to jaw pain.

Traditionally, experts believe TMJ involvement to be rare in people with PsA. While there is some disagreement from older studies, more recent research suggests that those with PsA do not have an increased risk of having TMJ involvement than the general population. However, those with PsA and TMJ involvement tend to experience worse symptoms.

A person should seek advice from a doctor or dentist if they start to experience jaw problems, whether or not they have a diagnosis of PsA.

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.

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PsA can affect the TMJ just as it can affect other joints in the body.

Some research suggests that jaw pain may affect 29–35% of people with psoriasis and PsA, similar to the rate in the general population. However, only around 40 people have reported it over the last 50 years.

However, a 2015 study states that psoriasis and PsA play a role in TMJ disorders.

Symptoms can include:

  • pain in the jaw joint or chewing muscles
  • jaw stiffness
  • pain that spreads to the face and neck
  • a reduced range of motion in the jaw
  • locking of the jaw
  • clicking or making other sounds when opening or closing the mouth
  • pain and tinnitus, or ringing in the ears
  • hearing loss
  • dizziness
  • the jaw being out of line
  • other symptoms related to PsA or psoriasis

People with jaw pain may find it hard to chew, eat, drink, speak, and sleep.

Treatments can help manage both symptoms and the systemic effects of PsA.

PsA mainly affects the joints, but it appears to have a link to gum disease and dental problems, too. Periodontal disease can also cause jaw pain.

A 2017 study suggests that the inflammation in PsA could increase the risk of gum inflammation, which can make tooth decay and gum disease more likely.

A 2019 review concluded that, compared with those without psoriasis, those with it were more likely to have:

  • periodontitis
  • more severe gum inflammation
  • more missing teeth
  • more bone loss

The study did not specifically refer to people with PsA, but it noted that periodontal disease was especially likely to affect people with severe psoriasis and PsA.

Researchers examined 220 people, half with PsA and half without. The participants with PsA were more likely to have advanced gum disease than those without.

While the scientists called for more research, they noted that people with PsA should receive treatment from a range of specialists.

How does PsA affect dental health?

Some home remedies can help people manage their jaw pain related to PsA.

It is essential to use these remedies alongside any treatment recommended by a doctor. PsA can cause permanent joint damage and medical treatment can help reduce the risk.

Some strategies can help relieve jaw pain at home:

Apply warm or cold packs

Applying a warm pack can help relieve jaw pain and stiffness. It can also make jaw exercises easier to do.

Cold packs can also help reduce inflammation. Always wrap a cold pack in a cloth before applying it to the skin.

Adopt a jaw-friendly diet

During a flare-up of symptoms, a person may wish to follow a diet of soft, pureed, or liquefied foods. These are easier to consume and give the jaw a chance to rest and heal.

Here are some tips:

  • avoiding chewy and crunchy foods, such as crusty bread, chips, and chewy meats
  • opting for cooked, instead of raw, vegetables and fruits
  • making smoothies with fresh vegetables and fruits
  • eating soups
  • pureeing foods to make them easier to swallow

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 habits, such as biting fingernails or clenching the jaw, as these can stress the jaw
  • taking time away from activities that require extensive talking, such as lectures and meetings

Reduce stress

High stress levels can cause a person to grind their teeth and clench their jaw more often. 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 trigger psoriatic flares.

Use an occlusal splint

Also known as an intra-oral appliance, this is a type of mouthguard. It can help ease pain by allowing the chewing muscles to rest in a neutral position, relieving pressure on the jaw.

The appliance should not result in any changes to the teeth or bite. However, it is unclear how effective these appliances are.

Seek physical therapy

A physical therapist can train a person in specific exercises to relieve PsA symptoms in the jaw and other joints.

Research from 2018 suggests that physical therapy can help with TMJ symptoms and pain.

Physical therapy for the jaw may involve:

  • jaw movements
  • stretches
  • adjustments to the positions of the body and head

Alternative pain relief

Acupuncture or using a transcutaneous electrical nerve stimulation (TENS) machine may help relieve discomfort. However, there is little evidence to support the effectiveness of either approach.

Exercise

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

Some people may have their TMJ symptoms go away on their own.

Inflammation and an overactive immune response cause most PsA symptoms, including those in the jaw. Doctors treat PsA-related jaw pain by addressing one or both of these issues.

Treatments aim to:

  • relieve pain
  • lower inflammation
  • reduce disease activity

Here are some treatments a doctor may suggest:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Examples include ibuprofen, aspirin, and naproxen.
  • Corticosteroid injections: These reduce swelling and pain, but there is a risk of joint inflammation and cartilage damage and doctors prefer not to prescribe them, if possible.
  • Botox injections: These work by inducing muscle paralysis. The effect lasts up to 6 months but only reduces pain by around 25%.
  • Arthrocentesis: A doctor flushes out debris in the joint and adhesions that restrict movement. To do this, the doctor flushes saline under pressure through a needle into the joint.
  • Biologic drugs and disease-modifying antirheumatic drugs (DMARDs): Current guidelines recommend these drugs to reduce the severity of PsA symptoms and the risk of permanent damage. They affect the way the immune system works to limit disease activity in the body.

Here are some prescription medications for TMJ pain that is not specifically related to PsA:

  • antianxiety drugs
  • antidepressants
  • anti-seizure medications

There is not enough evidence to support the use of many treatments for TMJ pain. For this reason, experts recommend avoiding surgery or other treatments that cause permanent changes to a person’s jaw, joints, teeth, or bite.

There is no single test for PsA or TMJ problems.

A doctor will:

  • ask about symptoms in the jaw, other joints, and any skin or nail symptoms
  • review the individual’s medical history, including a history of psoriasis or PsA
  • carry out a physical exam of the jaw, other joints, and the skin and nails if they suspect PsA

They may also recommend some diagnostic tests, such as:

If a person has a diagnosis of PsA and develops jaw problems, the doctor may investigate to see if there is a link.

Here are some questions people often ask about arthritis in the jaw.

Can jaw arthritis be cured?

There is no cure for jaw arthritis, but 80% of people improve with conservative measures, such as adopting a soft diet, reducing jaw movement, applying warmth, taking ibuprofen for pain, going to physiotherapy, and wearing a type of mouthguard.

For PsA, a doctor may suggest prescription drugs — for instance, biologics — to slow the progression of the disease and reduce the severity of symptoms and frequency of PsA flares.

Is TMJ pain common with psoriatic arthritis?

Temporomandibular joint (TMJ) pain is a common problem, but it does not commonly result specifically from PsA. TMJ pain affects 29–35% of people with psoriasis and PsA, and the general population experiences a similar prevalence. However, according to some older studies, 90% of people with PsA say they have some issues with their jaw.

Should I go to the doctor or the dentist?

People with jaw pain can see either a doctor or a dentist. They can then advise on specialist treatment, if necessary.

Psoriatic arthritis is an autoimmune disease that causes inflammation of joints and tissues. It often occurs with the skin and nail symptoms associated with psoriasis. It causes pain and stiffness in the joints, and in some cases, it can affect the jaw.

Temporomandibular joint pain can happen without PsA, and a doctor will prescribe the same pain relief treatment regardless of its cause.

However, if a doctor concludes that a person’s TMJ pain results from PsA, they will discuss a PsA treatment plan with the individual to help provide relief and possible remission.