Temporomandibular joint involvement in rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis

The aim of the present study was to estimate the prevalence of temporomandibular joint (TMJ) symptoms and clinical findings in Albanian patients with rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis. The authors examined 124 consecutive hospitalized patients (88 with rheumatoid arthritis, 22 with systemic lupus erythematosus and 14 with systemic sclerosis) and 124 age- and gender-matched healthy controls using a questionnaire and an oro-facial clinical examination for assessing the presence of TMJ sounds, pain in the TMJ area, tenderness of masticatory muscles and limited mouth opening. Significantly more patients (67%) reported TMJ symptoms than controls (19%). A significantly higher proportion of patients (65%) exhibited clinical signs of temporomandibular dysfunction compared with controls (26%). The most frequent findings in rheumatoid arthritis were temporomandibular sounds and pain. Pain was found in a significantly higher proportion in patients with systemic lupus erythematosus compared with controls. Difficulty and limitation in mouth opening were observed in the majority of systemic sclerosis patients, and in only a minority of rheumatoid arthritis patients. This study supports the notion that TMJ examination should be encouraged in the rheumatology setting and clinicians should be able to provide pain management and patient support.