Question About Ankylosing Spondylitis/Spondyloarthritis and Jaw/TmJ

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Mugz

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Hi!

I haven’t posted on the site in quite some time and opted not to resurrect my old Lions, Tigers and Dentists thread. While the thread may be dormant, my jaw pain (and dental fear) is not. I’ve had a terrible time with overall joint pain including TMJ which I had anyway but seems to have escalated following several doses of methotrexate and prednisone this month to treat what was previously diagnosed as rheumatoid arthritis and now seems to be more specifically diagnosed as Ankylosing Spondylitis (AS). According to my rheumatologist they are all treated basically the same way. My question is A. Have you seen this with AS or methotrexate before and B. Is there anything that helps? I’m heading back on biologics as soon as insurance approves but am seriously, 100% miserable and for the record, I am not a wimp.

In the spirit of full disclosure..I do happen to have a “free range” cavity that’s been unchecked for a few years - 4 to be exact - but this is not sharp, tooth pain, it’s all over aching jaw, swollen cheek-face pain. I can’t find a comfortable way to rest my jaw. Please don’t tell me this medicine could turn my happy, little free range cavity into a soul-sucking pit of dispair in the span of a month.
 
Gordon

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A: No sorry. It's rare for AS or Rh disease to affect the TMJ for some strange reason.

B: What have you tried for the TMJ in the past?
 
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Mugz

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Thank you for taking the time to reply. Initially I had issues with osteoarthritis as well and all of the joint pain, specifically TMJ was treated with Celebrex then meloxicam and eventually sulindac but I sadly have developed allergies to all NSAIDs in recent months which; now that I think about it, may be why I’m so uncomfortable - that was my “go to” relief as well as heat, soft foods and massage.

The clicking and popping I can deal with but the pain and tightness and getting stuck have got to go. Any suggestions at all are welcome. Thank you for your time.


A: No sorry. It's rare for AS or Rh disease to affect the TMJ for some strange reason.

B: What have you tried for the TMJ in the past?
 
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comfortdentist

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Hi Mugz
I agree with Gordon in not seeing RA or AS affecting the TMJ much. Now this doesn't include juvenile RA which can indeed destroy the TMJ.
Stay on top of the insurance and document the efforts.
RA is associated with periodontal disease. In fact periodontal disease is considered a risk factor for RA
 
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Mugz

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Thanks for the insight, Dr. Kimsey and Gordon. Asked the pharmacist tonight and he said it’s most likely not the drugs so I’ve put a call into the rheumatologist. It’s so uncomfortable I can hardly talk and my face is definitely puffy. Go figure.

I’m very happy to finally have a new dr connecting all the “autoimmune dots” but wish I felt better. Hoping in time. Perio will be a problem unless my home brushing and flossing is enough. The biologics don’t fix the fear factor, I’m afraid. Do they keep perio at bay?

Thank you again for your helpful replies. Much appreciated.
 
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comfortdentist

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Consider seeing a MD from UF.
 
Gordon

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Physiotherapy can help with TMJ symptoms, ultrasound and low energy laser for instance.
 
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Mugz

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Thank you, Gordon. Are these treatments typically done as part of independent physical therapy outside a dental office? If so, that may be a great option! If it is done in conjunction with dental visits we are back to square one, I’m sorry to say...unless; of course, I consider seeing a MD from UF. A thought I am seriously entertaining.

Thank you for the suggestions and for taking the time to read and reply.
 
Gordon

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Don't know how it works in the US, in the UK NHS I'd refer you to the physio department and they'd get on with it :)

Comfortdentist might be able to help from a US perspective.
 
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Mugz

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Thank you for your reply. Hoping it’s the same in the US.
 
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Mugz

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Rheumatologist switched meds. Said she sees jaw pain a lot but usually both sides, not typically just one. Trying Leflunomide instead. Starting to worry it may really be pain from the hole in my molar. Can steroids make teeth more sensitive?
 
Gordon

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Not in my experience but it seems to make them more brittle.
 
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Mugz

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Does brittle equate to breaking more easily?
Does the jaw bone become brittle as well?
In some alternate universe where I was actually able to muster the courage I would like to replace the tooth I had extracted last year with an implant. The bone graft I had done at the time of extraction was a complete bust and didn’t take. Would being on steroids for most of the year make implant placement impossible? Do they tend to fail more often in patients with autoimmune issues?

I know I really need to treat the teeth I do have before replacing the one I don’t but thought I’d ask. Thanks for reading, I appreciate your help!
 
Gordon

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Yes.
No.

Comfortdentist is your man for implants, I'll let him answer the other ones.
 
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Mugz

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Thanks for your help, Gordon. I appreciate it!
 
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Mugz

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MY MARTHA IS BACK!!! Hello, Friend!! How are you? Happy to ”see” you again!! What IS it with us? Just can't seem to shake the dental thing and boomerang right back here, don't we? Same story, same teeth, different year. Maybe we should resurrect the Lions and Tigers thread of epic proportions and get the band back together!

Fearful and Collegebound popped in recently. I've become more of a lurker these days. I can't really tell people it gets better until it actually does, I suppose. Hope you are happy and well and life has been treating you kindly.
 
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Martha55

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MY MARTHA IS BACK!!! Hello, Friend!! How are you? Happy to ”see” you again!! What IS it with us? Just can't seem to shake the dental thing and boomerang right back here, don't we? Same story, same teeth, different year. Maybe we should resurrect the Lions and Tigers thread of epic proportions and get the band back together!

Fearful and Collegebound popped in recently. I've become more of a lurker these days. I can't really tell people it gets better until it actually does, I suppose. Hope you are happy and well and life has been treating you kindly.
I am so tickled to hear from you!!!! I've been having horrible issues once again with my teeth. Did you read my post? I wont drone on and on about it (although I very much want to because I am obsessed at the moment) but it appears as though I've got a complicated problem with no easy answer. I was hoping I was just done with all this crap but honestly it just feels like the more dentistry I have done the worse it gets. Now I'm worried that so many repeated dental procedures have destroyed the trigeminal nerve and I will be toothless and in pain for the rest of my life.
It never ends.….
 
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FearfulInMA

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Hello to you both!!! Mugz - you know how I do miss the old Lions & Tigers thread and the old crew :)

I’m sorry to hear you are both having a miserable time of it all. It’s really very unfair!! I don’t have any good advice, just wanted to offer a virtual hand to hold and virtual shoulder to cry on. Hang in there!!
 
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