PsA is associated with jaw joint problems and periodontal disease, leading to various dental issues. These complications are often treatable with medication, lifestyle changes, or physical therapy and rarely with surgery.

Psoriatic arthritis (PsA) most often attacks and damages joints in your hands, feet, wrists, knees, neck, and spine. Yet it also may affect the temporomandibular joint (TMJ) in your jaw and cause other dental issues.

Problems with your TMJ are referred to as temporomandibular joint disorder (TMD). TMD causes painTrusted Source and difficulty moving your jaw.

Up to 35%Trusted Source of people with PsA have TMD. When you have PsA, your TMD symptoms may be more severe. TMJ pain often starts in the morning or late afternoon. It may hurt more when you chew.

The pain can spread from your jaw to other parts of your face and your:

  • shoulder
  • neck
  • back

Some people with TMD report having headaches or earaches. Other symptoms of TMD may include:

TMD can make you tense or clench your jaw, which, in turn, worsens TMD. Eventually, your TMJ may wear out completely, at which point you may need surgery.

There’s also a link between PsA and gum infection (periodontitis).

Periodontitis starts when bacteria build upTrusted Source on your teeth and gums. These bacteria release toxins that produce inflammation, which damages your gums and can lead to tooth loss.

Psoriasis and PsA are inflammatory diseases, increasing your risk for periodontitis and tooth decay. The more severe your PsA symptoms, the more likely you will have gum inflammation.

Dental implants are part of the treatment for tooth loss. These fake roots go into your jawbone to hold artificial teeth called crowns.

Biologics for PsA treatment may cause problems with dental implant surgery. These drugs target specific cells and proteins of your immune system, which may increase your risk of infection.

You may need to switch PsA medications or take antibiotics before oral surgery to prevent infection.

It’s unknown whether having PsA might make dental implants more likely to fail. Still, it’s a good idea to let your dental surgeon know about your PsA before surgery.

A small 6-year observational study from 2022 found that rheumatoid arthritis caused failure in 1 out of 12 people (8.3%) who received dental implants.

A 2019 research review, however, found that immunocompromised conditions didn’t impact dental implant survival. More research is necessary to determine if PsA affects dental implant failure.

Lifestyle changes, medications, physical therapy, and, in some cases, surgery may help treat dental problems caused by PsA.

Anti-inflammatory drugs and disease-modifying antirheumatic drugs (DMARDs) that treat PsA may also prevent jaw damage. These medications reduce inflammation to relieve pain and protect joints.

Lifestyle changes

Along with taking medication your doctor prescribes, try these lifestyle changes:

  • Rest your jaw until your symptoms improve.
  • Avoid eating nuts and other hard foods and chewing gum. Stick to soft foods.
  • Practice relaxation techniques to help ease tension in your jaw.
  • Ask your dentist to fit you for a mouthguard, which you can wear while sleeping to stop you from grinding your teeth.
  • Hold an ice pack or heating pad to your jaw.
  • Rub on an arthritis pain cream (but ask your doctor first).

Physical therapy (PT)

PT is another treatment for TMD. Your therapist can teach you exercises to stretch your jaw and strengthen the muscles that support it.

You’ll also learn how to keep your head and neck in better alignment to avoid putting extra strain on your jaw.

Surgery

It’s rare to need surgery for TMD, but it may be an option if other treatments don’t improve your symptoms.

Arthroplasty is performed through small incisions. The surgeon removes scars and areas of thick tissue that prevent your jaw from opening and closing properly.

Open surgery may be an option if the surgeon needs to repair or replace the damaged joint. Open surgery is riskier than arthroplasty, however, and it’s only done when absolutely necessary.

Early treatment of TMD is key to preventing long-term joint damage. If you notice any clicking, popping, or pain in your jaw, see a dentist and the rheumatologist who treats your PsA. They might send you to a specialist.

Practice good oral hygiene to prevent gum disease. Brush after every meal and floss once daily. See your dentist for regular check-ups.

If you plan to have oral surgery, let your surgeon know that you have PsA. You may need to take antibiotics beforehand or special precautions to prevent infection and other complications.

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