1. What Is Temporomandibular Joint Arthritis?
The temporomandibular joint is the only connecting point of the facial skeleton, consisting of the articular surfaces of the mandible and the temporal bone, along with other components such as the joint capsule, ligaments, articular disc, and retrodiscal tissue. The TMJ plays a vital role in opening and closing the jaw, performing actions such as eating, speaking, and swallowing.
TMJ arthritis, also called temporomandibular joint disorder or jaw joint inflammation, is a condition involving dysfunction of the jaw joint and surrounding facial muscles. It causes pain, muscle spasms, and imbalance in the articulation between the mandible and the skull, leading to reduced joint function and interference with daily activities of living.
This condition is common and can affect anyone, though women during puberty and menopause tend to have higher rates.
1.1. Symptoms of TMJ Arthritis
Pain in the temporomandibular joint often appears on one or both sides of the face. At first, it may be mild and self-limiting, but as the disease progresses, patients experience more persistent and severe pain, especially when chewing or eating.
Pain may radiate to the ears and nearby areas, making it difficult to open or close the mouth. Patients often find it hard to move the jaw, and clicking or popping sounds may be heard when opening or chewing. They may feel their mouth deviating to one side, causing jaw fatigue and facial asymmetry.
If the pain intensifies, chewing becomes more painful, and clicking sounds persist, it may indicate a more advanced stage requiring immediate treatment to prevent complications.
Additional symptoms may include headache, facial pain, neck stiffness, earache, temple pain, fatigue, and swollen lymph nodes near one or both TMJs. Chronic inflammation may cause hypertrophy of the chewing muscles on the affected side, resulting in facial swelling and asymmetry.
Serious complications include joint laxity, where the joint becomes loose, leading to dislocation or fusion. As joint components degenerate, adhesion may occur between the articular disc and bone surfaces. The most dangerous complication is disc perforation.
If not treated promptly, disc perforation can lead to destruction of the bone head and joint stiffness. In severe cases, the patient may find it difficult or impossible to open the mouth, significantly impairing their quality of daily activities of living.
Understanding early symptoms helps determine what medications for TMJ arthritis will be most effective.
1.2. Causes of TMJ Arthritis
There are many possible causes of TMJ arthritis, with the most common being joint diseases such as osteoarthritis, rheumatoid arthritis, and joint infection. Among these, rheumatoid arthritis accounts for about 50% of cases, allowing doctors to diagnose and determine the most appropriate medication for TMJ arthritis.
Studies show that the TMJ is often one of the last joints affected by osteoarthritis, typically after inflammation has involved other joints such as the wrist, knee, or elbow. TMJ osteoarthritis usually occurs in older adults, especially those with multiple degenerated joints.
Another common cause is facial trauma—due to traffic accidents, workplace falls, or sports injuries. Actions such as sudden wide mouth opening, nighttime teeth grinding, or excessive gum chewing can increase stress on the TMJ and elevate the risk of inflammation.
Additionally, dental issues such as misaligned teeth, crowding, extraction of molars or wisdom teeth, and psychological factors like stress or anxiety may contribute to TMJ arthritis.
2. What Medications Are Used for TMJ Arthritis?
Depending on diagnostic findings and underlying causes, doctors will prescribe specific medications for TMJ arthritis. The goal of treatment is to prevent disease progression, control pain, and maintain jaw function, so patients must consult a physician to determine the appropriate regimen.
2.1. Infectious Arthritis
In cases of bacterial infection, the primary treatment is antibiotics. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, diclofenac, or meloxicam may be combined for pain and inflammation relief. Drainage or aspiration may be required to remove pus if present.
2.2. Osteoarthritis
TMJ osteoarthritis is common in people over 50. Treatment is typically symptomatic, using the same NSAIDs as in infectious arthritis. Slow-acting chondroprotective agents such as glucosamine and chondroitin sulfate may be added. Local corticosteroid injections (e.g., hydrocortisone acetate or methylprednisolone acetate) can be used to reduce inflammation.
2.3. Rheumatoid TMJ Arthritis
In rheumatoid arthritis, the TMJ is usually affected after small joints (hands, feet) have been involved. Medications are part of the overall rheumatoid arthritis treatment plan and include NSAID medications (e.g., aspirin, diclofenac) or corticosteroids (e.g., prednisolone, hydrocortisone) in oral form. Other medications include disease-modifying antirheumatic drugs such as chloroquine, methotrexate, sulfasalazine, or biologic agents such as etanercept. Two or three agents are often combined for optimal efficacy. In severe cases, corticosteroid injections or surgery may be considered if joint adhesion causes inability to open the mouth.
2.4. Secondary Inflammatory–Degenerative TMJ Disorders
This form often develops after minor trauma or as part of TMJ dysfunction syndrome, which is common in women aged 20–40. Depending on the case, treatment may include psychological therapy, occlusal splint (bite guard) use, medications, surgery, or a combination of all approaches.
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