Temporomandibular disorders in women with psoriatic arthritis by history of psoriasis: a cross-sectional study

Temporomandibular joint involvement in psoriatic arthritis may result in impaired jaw function and reduced oral health-related quality of life. Patients with PsA have generally been analyzed as a single group regardless of psoriasis history, despite a reported association between psoriasis and TMJ involvement. To assess TMD symptoms, patient-reported outcome measures, and self-reported beneficial effects of systemic therapies and TMD-related treatment modalities in women with psoriatic arthritis, stratified by psoriasis history. A digital questionnaire was sent to members aged ≥ 18 years of the Swedish Rheumatism Association from March through September 2022. The study included 27 women with self-reported PsA diagnosed within the healthcare system. Descriptive analyses were performed to describe socio-demographic, disease-related, TMD-related, and patient-reported outcome measures stratified by psoriasis history. Pain during jaw activity (77.8%), TMJ sounds (74.1%), and morning jaw stiffness/pain/fatigue (66.6%) were the most reported symptoms in the total sample. The proportions were higher among women with a history of psoriasis compared with those without a history of psoriasis (81.8% vs. 75.0%, 81.8% vs. 68.8%, and 72.7% vs. 62.5%, respectively). Those with psoriasis history had higher median (Q1-Q3) JFLS-8 scores [18 (5-22) vs. 11.5 (8-17.5)] and higher mean (SD) OHIP-14 scores (16.7 ± 7.7 vs. 9.6 ± 7.4) than those without psoriasis history. A perceived beneficial effect of systemic PsA medication on TMD symptoms was reported by 40% and 30%, respectively. Occlusal adjustment in the psoriasis-history group and bite splint therapy in the other group were reported as the most received and most beneficial treatments in the respective. Women with PsA reported TMD symptoms and impaired patient-reported outcomes, with higher proportions reported in the psoriasis-history group. Self-reported beneficial effects of systemic and TMD-related treatments varied between groups. Findings should be interpreted cautiously given the small sample size and descriptive design. Further studies with larger samples are recommended.