Effect of Self‐Care on Temporomandibular Disorder in Drug‐Controlled Rheumatoid Arthritis Patients

Objectives Temporomandibular disorders (TMDs) in patients with rheumatoid arthritis (RA) can lead to orofacial pain and dysfunction of the temporomandibular joint (TMJ). Self‐care is a recognized primary intervention for controlling TMDs, offering a simple reversible treatment, since there is no specific treatment protocol for TMDs in RA patients. This study aims to investigate the effectiveness of self‐management in improving TMD symptoms in RA patients under drug control. Methods This prospective Phase II clinical trial included 64 drug‐controlled RA patients presenting with signs or symptoms of TMDs. All participants underwent baseline assessment using the RDC/TMD questionnaire, Numerical Analog Scale (NAS), and Helkimo Index, followed by a standardized clinical evaluation of jaw function and muscle/joint tenderness. Patients received structured self‐care education, including bilateral chewing exercises, mouth‐opening limitation within pain threshold, dietary modification, thermal modalities, parafunctional habit control, and therapeutic massage. Reminder messages and follow‐up phone calls were provided to reinforce adherence. Clinical examinations were repeated after 2 months to evaluate changes in pain intensity, jaw mobility, joint sounds, and TMD severity. Results Ultimately, reductions in TMD severity based on the Helkimo criteria and patient self‐report using the NAS, as well as reductions in the number of painful muscles and joints, improvement in maximum mouth opening, lateral and protrusive movements, and decreased jaw sounds were observed in patients. Conclusions Adherence to self‐management as the main component of treatment can be a highly effective, sustainable, and side‐effect‐free approach for managing symptomatic TMD in patients with RA. Clinical Significance Self‐care significantly reduced TMD pain, improved mouth movements, and decreased jaw sounds in RA patients with TMJ involvement. Trial Registration: Iranian Registry of Clinical Trials: IRCT N120221113056489

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Publication Details

Journal
International Journal of Clinical Practice
Published
2026-01-01
DOI
https://doi.org/10.1155/ijcp/3646656
Primary Topic
Temporomandibular Joint Disorders
Type
article
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article

Effect of Self‐Care on Temporomandibular Disorder in Drug‐Controlled Rheumatoid Arthritis Patients

Hosna Bahrami, Mahdieh-Sadat Moosavi, Seyedeh Tahereh Faezi
International Journal of Clinical Practice
Temporomandibular Joint Disorders
article

Effect of Self‐Care on Temporomandibular Disorder in Drug‐Controlled Rheumatoid Arthritis Patients

Hosna Bahrami, Mahdieh-Sadat Moosavi, Seyedeh Tahereh Faezi
article en

Abstract

Objectives Temporomandibular disorders (TMDs) in patients with rheumatoid arthritis (RA) can lead to orofacial pain and dysfunction of the temporomandibular joint (TMJ). Self‐care is a recognized primary intervention for controlling TMDs, offering a simple reversible treatment, since there is no specific treatment protocol for TMDs in RA patients. This study aims to investigate the effectiveness of self‐management in improving TMD symptoms in RA patients under drug control. Methods This prospective Phase II clinical trial included 64 drug‐controlled RA patients presenting with signs or symptoms of TMDs. All participants underwent baseline assessment using the RDC/TMD questionnaire, Numerical Analog Scale (NAS), and Helkimo Index, followed by a standardized clinical evaluation of jaw function and muscle/joint tenderness. Patients received structured self‐care education, including bilateral chewing exercises, mouth‐opening limitation within pain threshold, dietary modification, thermal modalities, parafunctional habit control, and therapeutic massage. Reminder messages and follow‐up phone calls were provided to reinforce adherence. Clinical examinations were repeated after 2 months to evaluate changes in pain intensity, jaw mobility, joint sounds, and TMD severity. Results Ultimately, reductions in TMD severity based on the Helkimo criteria and patient self‐report using the NAS, as well as reductions in the number of painful muscles and joints, improvement in maximum mouth opening, lateral and protrusive movements, and decreased jaw sounds were observed in patients. Conclusions Adherence to self‐management as the main component of treatment can be a highly effective, sustainable, and side‐effect‐free approach for managing symptomatic TMD in patients with RA. Clinical Significance Self‐care significantly reduced TMD pain, improved mouth movements, and decreased jaw sounds in RA patients with TMJ involvement. Trial Registration: Iranian Registry of Clinical Trials: IRCT N120221113056489

International Journal of Clinical PracticeVol. 2026(1)
Islamic Azad University Dental Branch of Tehran (IR), Tehran University of Medical Sciences (IR)
Openalex Percentile: Top 92%
Temporomandibular Joint Disorders
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