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#188942 - 11/08/10 03:36 AM TMJ and AS  
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Buckcat Offline
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Since everyone is asking dental questions lately, I thought I'd add mine to the pile. For the past year, my mouth opening has been getting smaller. My dentist commented on it and the increasing clicking. I've also been noticing that my jaw literally gets tired when I try to chew 'challenging' food like apples, hamburgers or steak. So, I went to a TMJ doc who thought the issue was my clicking side and that my other side was ok. The MRI showed the expected disk dislocation on the left but the right side has a torn ligament. The TMJ doc seemed floored. I asked if it could be from AS or Sjogren's (another condition I have) but he didn't seem to think so. Has anyone else had a torn jaw ligament? I know AS can affect ligaments but I've never heard of that. I do clench and grind my teeth at night but I've never broken teeth or woken up with sore jaw. Could I really clench/grind enough to tear a ligament without doing more obvious harm? The TMJ doc's solution is to make a new guard that I'll wear in the daytime, too (I just wear one at night now) but I have my doubts that a ligament in a body with inflammation will actually heal. Thoughts?

#188945 - 11/08/10 04:57 AM Re: TMJ and AS [Re: Buckcat]  
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canadianeh Offline
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I wonder if the ligament damage is due to the imbalance from the dislocation on the other side? TMJ's can be affected by AS resulting in primary inflammatory arthritis and secondary degenerative arthritis.


Undifferentiated Spondyloarthropathy (HLA B27 +)Dx Jan 08,on flurbiprofen (Froben), pantoprazole. One THR (other pending),episcleritis,peripheral and axial arthritis. Recently stopped Enbrel due to skin rash. Humira stopped due to double vision. Surgery for sinus infection and double vision. Back on Humira...
#188950 - 11/08/10 10:05 AM Re: TMJ and AS [Re: canadianeh]  
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cemc Offline
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is it something to talk to your rheumie about as well?

I'd be interested to hear your answers as I am having increasing jaw clicking a difficulty with pain when chewing.


Cauda equina type neurogenic bladder problems. Coeliac disease. Sicca syndrome. Ataxic gait and use crutches. Non-specific gut problems. Current treatment: Low dose naltrexone, low starch diet (Guts shredded by NSAIDs. Previously diclofenac worked well, not eligible for anti-tnfs, hypersensitivity to SSZ). Also short bursts of pred for bad flares
#188951 - 11/08/10 11:35 AM Re: TMJ and AS [Re: cemc]  
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Wow, I've never heard of a torn jaw ligament outside of an accident. I've had TMJ for over 30 years, but it was under good control until this year. Now every time my PsA flares, my TMJ flares badly at the same time. I hate listening to the loud clicking every time I open my mouth or try to chew food.

I know that it's pretty common for folks with RA to develop major jaw problems from their RA, and since AS is a similar inflammatory disease, I wouldn't be surprised that it could affect us, too.


Psoriatic spondylitis, became severe within 3 years; on disability. Single, age 57. Failed Humira, Remicade, and methotrexate. Can't take NSAIDS or opioid pain meds. Also have adrenal insufficiency and thyroid issues.
#188954 - 11/08/10 02:08 PM Re: TMJ and AS [Re: Sundance]  
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A torn ligament sounds extreme. I've never heard of one in the jaw either. I'm a 22+ year veteran of the jaw clicking, can perform on demand (both sides) and have been an on/off nighttime grinder for years as well.

Buckcat, have you taken any meds that are known to cause tendon rupture? Cipro and related antibiotics come to mind... A quick internet scan seems to indicate these are usually caused by injury - something forcing the jaw into a wider range of motion than it can handle. In your case since you already have TMJ issues maybe that could have simply been opening wide to take a bite of a big sub?!

Per this website (which I don't vouch for, lol, but it cites a textbook as source), a mild sprain (small tear) can heal on its own without intervention. Sounds like you may want to see the MRI report and make sure the sprain was properly described/graded, and if your TMJ expert has no clue on what to do next (if anything) maybe get referred to an oral surgeon.

http://www.mdadvice.com/library/sport/sport265.html

cemc, your pain may be caused in part by nighttime clenching or grinding ... do you know if you do this? If you grind the dentist will easily see signs of the wear. Clenching results in waking up with a sore jaw.


Jen, 42, happy partner of James and Moma to Evan, 14, & Lucy, 12.5 (Crohn's dx @ age 3; on Remicade since April 2010.) I take piroxicam, Flexeril, & Nucynta ER nightly. 3 anti-TNFs didn't pan out for me.

"Science is the father of knowledge, but opinion breeds ignorance." -- Hippocrates
#188978 - 11/08/10 04:19 PM Re: TMJ and AS [Re: JenInCincy]  

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just speculation here based on my own experience. AS definitely affects our tendons, bodywide. i have great jaw pain and have lumps of bone where the tendons meet my jawline. you can actually see the bump. when i use voltarin cream (nsaid) on the side of the jaw, the swelling goes down.

in enthesitis, where bone deposition is occurring, the bony area being created weakens the tendon where it inserts/originates at the bone. and that could cause the tendon to rupture and/or snap.

AS is all about the enthesitis. i have it in spades in my bottom right jaw. my dental hygienist could not believe the size of the bone deposition had grown when i saw her last week.

and yes, my jaws barely open some days when the inflammation is the worst. so, in my convoluted way of writing, sorry. i think absolutely, the AS could be the cause of the rupture.

take care prayers and peace, sequoia

ps, i think you have uncontrolled inflammation. need something to bring it down. just my opinion

Last edited by sequoia; 11/08/10 04:20 PM.
#188983 - 11/08/10 07:07 PM Re: TMJ and AS [Re: ]  
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outlier Offline
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I have the same issues (not the torn jaw ligament, as far as I know). I am hoping to talk to my Rhemy about it on Friday. It drives me nuts!
The internet (webmd, TJM org site and some google searching) seemed to think TMJ and Arthritis went together.
I am positive I don't Grind my teeth. I might clench my jaw, but I doubt it. I think it's related to my AS (and the secret plot my body has to keep me from enjoying food, known as Crohns).
What kind of doc is a TMJ doc?


Diagnosed: ankylosing spondylitis Feb '10, Crohn's Nov '09, GERD Aug '09, Scleritis May '08, Scoliosis '92
HLA-b27 negative
Surgery: Scoliosis Spinal fusion July '99
Current Meds: Humira, Asacol, Reglan, Dexilant, Tramadol, Maalox, and Xibrom (Bromfenac).
No more sulfasalazine and Iron
#188992 - 11/09/10 01:37 AM Re: TMJ and AS [Re: outlier]  
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equusfelix Offline
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I too, have developed TMJ since being diagnosed with AS, but I don't have the ligament problem. If I chew on gum, eat meat, etc. my jaw very easily "pops out" or dislocates. My dentist taught me how to "pop" my jaw back into the joint, but the whole process is extremely painful. My dentist was convinced that the TMJ was from the AS, but when I told my rheumatologist, he seemed unimpressed.

Anyways, I was curious is there ligament involvement with AS, too? I thought it was predominantly tendon involvement. If it is predominantly tendon involvement, then that may be helpful as far as whether the torn ligament is related to the AS.

Pax tecum,

Becky

#189084 - 11/10/10 04:52 AM Re: TMJ and AS [Re: equusfelix]  
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Jean Angel Offline
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TMJ is just another form of the arthritis you ahve. I also ahve had problems with it for many yrs. I have a spling. I make sure and wear it at night, but many times have to wear it during the day.

#189095 - 11/10/10 06:25 AM Re: TMJ and AS [Re: Jean Angel]  
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LisaNR Offline
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TMJ here too. Best thing is a night splint. My insurance will not cover TMJ. Perhaps if said it was AS? humn?


LisaNR

Undiff. Spondylitis, Fibromyalgia, Chronic Fatigue, Chronic Dry Eye, IBSD, GERD, Chronic Gastritis, Auto Immune Hashimoto's (Thyroid)
PCOS, Insulin Resistance, High Cholesterol, Gallbladder removed, Hidradinitis Suportiva, B-12 Deficient, Migraines, TMJ, Chronic Rhinitis and Sinusitis, Allergies, Rosacia, Vitamin D Deficient, Generalized Anxiety Disorder (Spondy is stressful!), etc. etc. etc.
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