On the involvement of the temporomandibular joint in rheumatoid arthritis

64 patients with rheumatoid arthritis (RA) were examined for temporomandibular joint (TMJ) symptoms as well as for the severity and incidence of their symptoms. In detailed interviews, a total of 34 patients (53.1%) reported TMJ symptoms, the main complaints being problems during opening and closing of the mouth (45.2%). RA patients with TMJ symptoms differed significantly from those without TMJ symptoms (p < 0.01) in the duration (121.7 +/- 100.5 months vs. 37.1 +/- 27.6 months) and the state of activity of the basic disease. The patients subjectively evaluated the severity of the TMJ symptoms as mild to moderate (grade: 2-3; severity: 241 +/- 1.01). Almost 70% reported occasional symptoms, 22.5% frequent symptoms and 10.6% permanent symptoms (p < 0.01). 61.8% (21/34) of the patients showed no radiographic change in the shape of the TMJ condyle, whereas 11.8% (4/34) demonstrated a change on one side an 26.4% (9/34) a change on both sides. There was no difference in the severity of the TMJ symptoms between patients with an unchanged condyle (n = 21; severity: 2.33 +/- 0.96) and patients with changes in condylar shape (n = 13; severity: 2.5 +/- 1.12). A frequent involvement of the temporomandibular joint in RA can be considered certain. The symptoms, which were generally moderate, can cause a marked impairment of daily used functions, such as chewing and speaking.