Initial treatment of temporomandibular joint (TMJ) arthritis in patients with juvenile idiopathic arthritis (JIA)

bDMARD: biologic disease-modifying antirheumatic drug; csDMARD: conventional synthetic disease-modifying antirheumatic drug; JIA: juvenile idiopathic arthritis; MTX: methotrexate; NSAID: nonsteroidal antiinflammatory drug; TMJ: temporomandibular joint; TNF: tumor necrosis factor.

* Features suggestive of moderate to severe TMJ arthritis include clinically significant jaw dysfunction (eg, difficulty eating or talking) and notable abnormalities on physical examination (eg, jaw asymmetry, micrognathia, retrognathia).

¶ The dose and duration to expect full efficacy varies by agent; as examples, most csDMARDs are fully effective after 3 months, while bDMARDs may reach full efficacy somewhat earlier. For more information on specific medications, refer to UpToDate content on the treatment of JIA.

Δ DMARDs vary in their efficacy for treating various manifestations of JIA, including peripheral and axial arthritis, enthesitis, and dactylitis, as well as related comorbid conditions (eg, uveitis, psoriasis, inflammatory bowel disease). There are no data to favor one bDMARD over another for treatment of TMJ arthritis in JIA. For more information, refer to UpToDate content on JIA.