Will I ever chew again?

Dear Ms McDaniel,

I saw your article on arthritis on April 14 and found it interesting as I am afflicted with this disease in every joint in my body. I am now suffering from temporal mandibular joint syndrome (or temporo-mandibular joint disorder or TMJ) as a result of osteo-arthritis. My questions are: Is there something besides glucosamine and chondroitin and fish oil that will help? Do glucosamine and chondroitin really grow back the cartilage? And my greatest hope, will I ever be able to chew again?

With my best regards.

- Natalie

Dear Reader,

Thank you for writing. As I am an arthritis survivor myself, I do feel your pain. To answer your questions:

Yes, there are other supplements and medications apart from glucosamine and chondroitin which may help TMJ syndrome.

Yes, glucosamine helps rebuild lost cartilage and chondrotin strengthens joints, ligaments and tendons.

I do not know the extent of your TMJ damage by osteo-arthritis, and since as a pharmacist my ability to diagnose and give prognoses on medical conditions is limited, I cannot say whether you will chew again. In many cases some symptoms improve after several months, depending on the severity of the condition. The temporo-mandibular joint is regarded as the most complicated joint in the body. It is on either side of the face where the skull meets the lower jawbone, just in front of the ears. It sustains a large amount of pressure during chewing, and yet its cartilage is not as strong as that in other joints!

I trust that by now you are under the care of a rheumatologist, a medical specialist in bones, joint and muscle disorders (for your arthritis) and/or a maxillo-facial surgeon, a dentist who treats disorders of the jawbone, mouth, neck, face, skull and associated body parts.

Osteoarthritis supplements

Previously, I listed the benefits to joints in using glucosamine 1,500mg daily, chondroitin 1,200mg daily, omega-3 fatty acids 3,000mg daily, vitamins A, D, E, C, selenium and boron.

A recent study, funded by Seven Seas Ltd shows some promise. Glucosamine, in combination with omega-3 fatty acids, seems to achieve better improvements in joint health, when compared to, using glucosamine alone. Apparently they work in synergy to slow the inflammation process in osteo-arthritis, and to support the rebuilding of lost cartilage.

Several herbs exert anti-inflammatory effects in arthritis. These include cayenne, ginger, noni, boswellia and alfalfa. Remember to consult your doctor or pharmacist before you begin to take supplements. They may carry side effects, and may work against other drugs or medical conditions.

Pain medication

Your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, diclofenac and naproxen for your arthritis woes. Drugs called COX-2 inhibitors (like celecoxib and etoricoxib) also ease inflammation and pain.Like herbal supplements, these conventional drugs have potential side effects and warnings against use in certain medical conditions. The doctor or dentist may decide to give you a steroid injection into the temporo-mandibular joint to ease the severe pain and inflammation. The first line of approach is to take the stress off the temporo-mandibular joint:

Rest the jaw as much as possible.

Eat soft foods.

Do not open the mouth wide.

Wearing a splint (biteplate) or night-guard over the teeth can control the muscle tightness and take the stress off the joint.

Dahlia McDaniel is a pharmacist and final year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.