Jaw problems aren’t usually thought of as a common symptom of lupus. However, several MyLupusTeam members have noticed their jaws get tired while chewing. One member asked, “When I’m eating, my jaw and mouth get so tired from chewing. It’s almost like a workout. Does anyone else deal with this?”

If you’ve also noticed this symptom, you’re not alone. In fact, studies have found that systemic lupus erythematosus (SLE) can change your chewing abilities.

Jaw Problems and Lupus

A 2021 review of studies on lupus and oral health found people with lupus have an increased risk of diseases of the jaw, teeth, and gums. Problems with the muscles, bones, joints, or nerves in and around the jaw are known as temporomandibular disorders (TMDs).

Common symptoms of TMDs include:

• Jaw pain
• Headaches
• Ear pain
• Dizziness
• Jaw popping or clicking
• Limited range of motion in the mouth
• Changes in your bite (how your upper and lower teeth fit together)
• Grinding or clenching your teeth
• Tooth sensitivity

MyLupusTeam members have frequently discussed TMD symptoms. One member shared, “I often have jaw pain. I can’t open my mouth wide. If I chew gum, I can’t do it for long because it causes so much pain. And I often have to avoid ‘chewy’ foods because it is too painful and exhausting to do all that chewing.”

Here are some of the reasons why having lupus can make your jaw feel tired while chewing.

1. Jaw Pain

Lupus symptoms include joint pain and swelling. Although lupus most commonly affects other parts of the body, such as the joints in your hands, wrists, knees, and feet, it may also affect the joints in your jaw called the temporomandibular joints (TMJs).

The TMJs are the joints on either side of your head that connect your lower jaw to your skull. These are very complex joints that move up and down, side to side, and forward and backward.

More than one MyLupusTeam member has asked, “Does anyone deal with TMJ issues?” Another member lamented, “I sometimes have to stop in the middle of a meal just to massage my jaw. It’s very painful, and from that pain, it can turn into a migraine.”

Treatments for lupus can help improve TMJ pain caused by lupus. There are also treatments to directly relieve your jaw pain. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen
• Tricyclic antidepressants, such as amitriptyline (Elavil)
• Muscle relaxers, such as cyclobenzaprine (Flexeril), metaxalone (Skelaxin), or methocarbamol (Robaxin)
• Relaxation techniques to reduce stress
• Physical therapy to strengthen the jaw muscles
• Injections into the joint with medications like corticosteroids or botulinum toxin type A (Botox) to help relieve pain
• Surgical procedures if other treatments don’t work

Talk to your rheumatologist or a dentist if you have jaw pain that doesn’t go away. You should also tell them if you can’t open or close your mouth completely. Lupus can cause a looseness (called laxity) in the tendons, which can move bones out of position, making your jaw feel stuck. MyLupusTeam members have experienced this symptom. “Over the last year, I have lost the ability to open my mouth all the way,” shared one member.

2. Dry Mouth

People with dry mouth can have difficulty eating, swallowing, and tasting food. More severe symptoms of dry mouth include tooth decay, joint pain, and dry eyes.

Dry mouth — also known as xerostomia — is caused when the salivary glands don’t produce enough saliva. One study estimates that about 79 percent of people with lupus experience dry mouth.

Dry mouth can also be caused by another condition called Sjögren’s syndrome, which often occurs along with other autoimmune diseases. It’s estimated that between 14 percent and 18 percent of people with lupus have Sjögren’s syndrome.

A MyLupusTeam member shared, “I have also been diagnosed with Sjögren’s. The Sjörgen’s causes dry mouth, which doesn’t produce enough saliva to help soften the food to help with chewing.”

Some types of dry mouth can be helped with a change in medication. However, there’s no cure for Sjörgen’s syndrome, so treatment involves making you more comfortable and preventing complications. Treatment for dry mouth includes:

• Preventing tooth decay by brushing your teeth twice daily and using toothpaste and a mouthwash made for dry mouth
• Promoting saliva production with sugar-free candy, ice cubes, and frequent sips of water
• Keeping your mouth moist with artificial saliva products, lip balm, humidifiers, and water
• Avoiding foods and drinks that can make dry mouth worse, including caffeinated beverages, alcohol, carbonated drinks, and spicy, sugary, or salty food
• Taking medications including hydroxychloroquine (Plaquenil), cevimeline (Evoxac), and pilocarpine (Salagen)

Talk to your rheumatologist if you notice symptoms of dry mouth, especially if they’re interfering with your ability to eat. It’s also important to discuss dry mouth with your dentist, so they can examine you for signs of tooth decay.

3. Muscle Pain and Weakness

Lupus can often cause muscle aches and pains — also known as myalgia. If your neck and shoulders are affected by lupus myalgia, it could impact your ability to use your jaw.

Lupus can also cause muscle inflammation — known as myositis — most commonly in the legs, upper arms, and shoulders. Muscle weakness is the most common symptom of myositis. If the muscles of your jaw, neck, or shoulders are affected, it may cause problems chewing.

Treatment of muscle pain and weakness can include medications to reduce symptoms, such as NSAIDs or corticosteroids. To help with jaw pain and weakness, a MyLupusTeam member suggested, “Try softer foods. Tough-to-chew food can be hard, especially if you are fatigued.”

Talk to your rheumatologist right away if you experience unusual muscle pain, soreness, or weakness. It’s also important to have a plan with your rheumatologist or dentist to keep your muscles active. Avoiding the use of muscles due to pain can worsen muscle weakness.

4. Medications

The side effects caused by some medications used to treat lupus could also cause problems chewing. Talk to your health care provider or pharmacist about the side effects of your medications to see if they might affect your ability to chew food. Never stop taking a medication without talking to your doctor first.

Corticosteroids

If you are taking a corticosteroid — such as prednisone — to treat lupus, you may experience a potential side effect of muscle weakness. Corticosteroids can also cause an increased appetite, making you eat and chew more than you normally would.

Antidepressants

It’s common for people with lupus to take an antidepressant to treat anxiety or depression. Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can cause you to clench or grind your teeth. Studies have found that it’s most common with the SSRIs fluoxetine (Prozac), sertraline (Zoloft), and venlafaxine (Effexor). Clenching and grinding your teeth over time can increase your risk of TMJ disorders.

Medications That Cause Dry Mouth

Several medications can cause dry mouth as a side effect. Examples of medications commonly taken by people with lupus that can cause dry mouth include:

• Antidepressants
• Fibromyalgia medications such as pregabalin (Lyrica)
• Some NSAIDs, like celecoxib (Celebrex)

Many other medications that may not be related to your lupus treatment can also cause dry mouth. Check the list of potential side effects of your medications to see if dry mouth is included. Other medications that may cause dry mouth include:

• High blood pressure medications
• Anxiety medications
• Allergy medications
• Muscle relaxants

If you have symptoms of dry mouth or recurring jaw pain, always let your doctor know. They may be able to change your treatment plan or recommend some therapies that can help.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Does your jaw get tired when chewing? Do you have any tips for managing jaw pain or dry mouth? Share your experience in the comments below, or start a conversation by posting on your Activities page.