Steroid Treatment for Temporomandibular Joint (TMJ) Disorder

First-Line Treatment Approach

The American College of Rheumatology conditionally recommends NSAIDs as initial therapy for TMJ pain and inflammation, though trials should be brief due to potential adverse effects 4, 5, 6
Occlusal splints/mouthguards are beneficial for patients with TMJ dysfunction as a reversible, safe, and low-cost intervention, according to the American College of Rheumatology 7, 5, 6
Physical therapy and jaw exercises are recommended to improve range of motion and reduce stiffness in TMJ disorders, as suggested by the American College of Rheumatology 7, 6

Intra-articular glucocorticoid injections should be considered only after failure of conservative measures, as indicated by the American College of Rheumatology 1, 3, 7
Steroids are indicated specifically for arthritis-induced refractory and symptomatic TMJ dysfunction, according to the American College of Rheumatology 1, 2, 3
The decision to use intra-articular steroids must consider the patient's skeletal maturity, as they are not recommended as first-line management in skeletally immature patients, as suggested by the American College of Rheumatology 1, 2, 5

Intra-articular lavage (without steroids) may be beneficial for TMJ arthritis-related symptoms and dysfunction in both growing and skeletally mature patients, according to the American College of Rheumatology 1, 2, 3
For patients with juvenile idiopathic arthritis affecting the TMJ, conventional synthetic DMARDs are strongly recommended for inadequate response to NSAIDs and/or intra-articular glucocorticoids, as suggested by the American College of Rheumatology 4, 5