How can bruxism cause headaches? Bruxism causes morning, tension, and migraine headaches via jaw muscle fatigue and trigeminal sensitization. Learn the types, triggers, and relief options.
Written by Ann C. McCulloch, MBA | Medically Reviewed by Bradley Allen Eli, DMD, MS
Rheumatoid arthritis in the jaw happens when the same autoimmune inflammation that affects the hands and feet in RA spreads to the temporomandibular joint (TMJ), causing pain, swelling, and stiffness — usually on both sides of the face. More than half of people with rheumatoid arthritis develop some degree of TMJ involvement, often only after the disease has already affected other joints in the body. Left unmanaged, it can progress to bite changes and permanent joint stiffening called ankylosis.
Rheumatoid arthritis in the jaw is more common than people think. The National Institutes of Health reports that the prevalence of temporomandibular disorders (TMDs) is substantially higher in people who suffer from rheumatoid arthritis. They also report that TMJ symptoms and disease severity are increased in people with rheumatoid arthritis. Population studies estimate that more than 50% of people with rheumatoid arthritis also suffer from TMJ issues.
Rheumatoid arthritis is a chronic inflammatory condition where there is an autoimmune attack against certain tissues in the body. While this autoimmune inflammation can affect many different parts of the body, it notoriously affects the lining of the joints. The intermittent inflammation in rheumatoid arthritis (called “flare ups“) causes swelling and pain in the joints and eventually leads to erosion and deformity, according to the Mayo Clinic. Flares can be driven by disease activity itself, but day-to-day factors such as stress can also make jaw symptoms feel worse during an active period.
There are several distinct clinical characteristics of TMJ disease in people with rheumatoid arthritis, including the following:
There are certain late-stage changes that can be severely debilitating. These include changes in the bite (malocclusion) and “ankylosis” (stiffening of the joint due to adhesions). Because these changes can result in facial and dental deformities, surgical correction is sometimes required, including TMJ reconstruction.
Rheumatoid arthritis is a complex disease affecting multiple organ systems. For this reason, a whole-body approach to treating rheumatoid arthritis is usually adopted, and it’s common for several medical professionals to be involved in the overall care. “A team approach to rheumatoid arthritis is the norm, with a rheumatologist leading the team. Good coordination of care is one of the best things we can do for rheumatoid arthritis patients”, explains Bradley Eli, DMD, MS, a specialist in orofacial pain and TMJ disorders.
Using medications to slow the progression of rheumatoid arthritis is a central aspect of treatment. The rheumatologist will typically be the one directing the medication strategy. There are specialized medicines used to fight rheumatoid arthritis, including disease modifying antirheumatic drugs (DMARDs) and other biologic medications.
For pain, non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be effective for rheumatoid arthritis of the TMJ. A 2022 clinical practice guideline published in Deutsches Ärzteblatt International found that TMJ involvement can be detected in 40–90% of people with rheumatoid arthritis or juvenile idiopathic arthritis, and that conservative treatment fails to control symptoms in fewer than 10% of cases — meaning most people improve without needing arthroscopy, injections, or surgery.
Aside from medications, there are supportive care measures you can take to help relieve TMJ pain from rheumatoid arthritis, especially during flare ups. These measures include:
During an active flare, deliberately resting the jaw can reduce additional strain on an already inflamed joint. In this sense, learning how to stop clenching your jaw requires more than just reading; it requires a system and tools. The measures above are available as part of the Speed2Treat® Home Healing Kit, which can be a useful starting point for managing inflammatory flare-ups of TMJ rheumatoid arthritis alongside a rheumatologist’s treatment plan.
Most TMJ flares from rheumatoid arthritis can be managed with medication and supportive care, but certain changes warrant prompt medical evaluation:
Yes. Rheumatoid arthritis can affect the temporomandibular joint (TMJ) just as it affects other joints in the body. TMJ involvement typically develops after RA has already affected other joints, and it tends to occur on both sides of the jaw rather than just one.
Many people describe tenderness, fatigue, or aching in the jaw that worsens with chewing. Some also notice popping or grinding sounds (crepitation), morning stiffness, and a gradual decrease in how far they can open their mouth.
Jaw pain is usually not among the first symptoms of rheumatoid arthritis. RA typically affects the hands, wrists, and feet before reaching the TMJ, so jaw involvement is more often a sign of established disease rather than an early warning sign.
Joint damage from rheumatoid arthritis, including erosion or ankylosis in the TMJ, generally cannot be reversed once it occurs. Early diagnosis and consistent disease-modifying treatment can slow or prevent further damage, which is why ongoing rheumatology care matters.
Soft foods, alternating hot and cold therapy, gentle jaw exercises, and short-term use of an anterior bite splint can help ease discomfort during flare-ups. These measures support, but don’t replace, the medications used to manage the underlying disease.
Surgery is uncommon and reserved for severe, longstanding cases where conservative treatment hasn’t helped and the joint has developed significant deformity or ankylosis. Most people manage their TMJ symptoms without ever needing surgical intervention.
