Temporomandibular disorders in patients with early rheumatoid arthritis and at-risk individuals in the Dutch population: a cross-sectional study

• Published in: Rheumatic & musculoskeletal diseases open Vol. 7; no. 1; p. e001485
• Main Authors: Kroese, Johanna M, Volgenant, Catherine M C, Crielaard, Wim, Loos, Bruno, van Schaardenburg, Dirkjan, Visscher, Corine M, Lobbezoo, Frank
• Format: Journal Article
• Language: English
• Published: England EULAR 01-01-2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: anti-citrullinated protein antibodies; Arthralgia - epidemiology; arthritis; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - epidemiology; Bruxism; Cross-Sectional Studies; Dentists; Disease; Humans; Jaw; Osteoarthritis; Pain; patient care team; Patients; Questionnaires; rheumatoid; Rheumatoid Arthritis; rheumatoid factor; Temporomandibular Joint Disorders - diagnosis; Temporomandibular Joint Disorders - epidemiology; patient care team; anti-citrullinated protein antibodies; arthritis; rheumatoid factor; rheumatoid
• ISSN: 2056-5933; 2056-5933
• DOI: 10.1136/rmdopen-2020-001485

ObjectiveTo evaluate the prevalence of temporomandibular disorders (TMD) in patients with early rheumatoid arthritis (ERA) and individuals at-risk of RA.Methods150 participants were recruited in three groups (50 per group): (1) patients with ERA (2010 EULAR criteria) (2) at-risk individuals and (3) healthy controls. All participants were tested for seropositivity of rheumatoid factor and anticitrullinated protein antibodies. A possible TMD diagnosis was determined according to the standardised and validated diagnostic criteria for TMD (DC/TMD) in five categories: myalgia, arthralgia, articular disc displacement, degenerative joint disease and headache attributed to TMD. Results were tested for the prevalence of TMD (all categories combined) and TMD pain (myalgia and/or arthralgia). To investigate a possible role for bruxism, a probable sleep and/or awake bruxism diagnosis was determined based on self-report and several clinical features.ResultsThe prevalence of any TMD diagnosis did not differ between the three groups. However, at-risk individuals more often had a TMD-pain diagnosis than healthy controls (p=0.046). No such difference was found between the ERA group and the control group. However, within the ERA group, seronegative patients had a TMD-pain diagnosis more often than seropositive patients (4/12 (33%) vs 3/38 (8%), p=0.048). Participants with a TMD-pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD-pain diagnosis.ConclusionThe prevalence of TMD pain is increased in individuals at-risk of RA and seronegative ERA patients, and is associated with bruxism signs and symptoms. These results suggest that health professionals should be alert to TMD pain in these groups.