Challenged by the jaw - an interview study on patients' experiences of temporomandibular disorders in rheumatic inflammatory diseases

PurposeRheumatic inflammatory diseases affecting the temporomandibular joint and the masticatory system (TMD) have been described as painful and limiting. However, the condition is often overlooked in primary care. The objective of this qualitative study was to explore and describe TMD-related experiences and perceptions of persons with rheumatic inflammatory disease, and to put this into a rehabilitation perspective.Materials and methodsSeven participants with rheumatic inflammatory disease and concomitant TMD were interviewed using a semi-structured interview guide. Giorgi's phenomenological method was used for analysis of the material.ResultsThe general structure of the results after phenomenological reduction indicated that the phenomenon could be described as the process of being challenged by the jaw. Five themes emerged from the analysis; 1. Physical challenges of the jaw and the struggle to retain control, 2. Shame and social challenges, 3. Worrying about the future, frustration, grief, and loss of freedom, 4. Defiance, endurance, and efforts to maintain self-esteem, and 5. Health-care experiences.ConclusionsTMD in rheumatic inflammatory diseases are complex problems associated with various challenges to the sufferer. An increased awareness of the condition and earlier interventions could reduce both suffering and worsening of the condition. The connection between the jaw and the rest of the body tends to be neglected.Questions about the jaw should be asked to detect eventual temporomandibular disorder (TMD) at an early stage to prevent worsening of the condition.Patient's experiences of TMD must be considered in the rehabilitation process.Health care providers are important for an earlier, more consistent, and more accessible diagnosis and treatment for this group of people.