Print this page

Medical Treatments

Early Therapy

Most cases of TMJ are temporary; thus, treatment is usually conservative.

Early therapy starts simply with jaw rest, using warm compresses (cold packs at first if an injury is present), and pain medication. Jaw rest can help heal injured or inflammed temporomandibular joints. Eat soft foods. Avoid chewing gum and eating hard candy or chewy foods. Do not open your mouth wide. Your doctor may show you how to perform gentle muscle stretching and relaxation exercises. Stress reduction techniques may help you manage stress and relax your jaw along with the rest of your body. Nonsteroidal anti-inflammatory medications and muscle relaxants are the most commonly prescribed medications. Other than in acute injuries, it is unwise to utilize narcotic medications early in TMD treatment.

The doctor may fit you with a splint or bite plate. This is a plastic guard that fits over your upper orlower teeth, much like a mouth guard in sports. The splint can help reduce clenching and grinding, especially for night bruxism. This may ease muscle tension. The splint should not cause or increase your pain. If it does, do not use it.

Physical therapy by an experienced therapist can decrease pain, mobilize the muscles/joints, and increase function. After stabilization many physical therapy modalities can be performed at home. If conservative and noninvasive techniques do not work, you may consider more advanced techniques.

Advanced Techniques

A more advanced procedure called arthrocentesis is performed in the doctor’s office or clinic under local anesthesia with or without sedation. Arthocentesis is basically mobilizing the joint and “flushing it out”. The procedure is carried out by inserting 2 needles in the temporomandibular joint to wash it out. One needle is connected to a syringe filled with a irrigant solution, and the fluid exits via the other needle. Many people find relief from the pain and return to almost normal. Sometimes, pain medication can be injected into the joint in a similar procedure. Your clinician may determine that your condition is too advanced for arthocentesis and he/she may recommend a more advanced procedure.

A last option, surgery, is often irreversible and should be avoided when possible. A variety of surgical procedures have been found to be efficacious in TMJ disorders. These can be categorized as follows:

  • Arthroscopic surgery – a small (< ¼ inch) telescope is inserted into the joint. The pathology is diagnosed and treated.. The most common arthroscopic procedure involved lyses (breaking up) adhesions (scar tissue) and lavage (flushing out).
  • Arthroplasty – This is also called “open joint surgery”. An incision is made in front of the ear, and the surgeon dissects down to the joint. After the joint capsule is opened, the disc is either repaired or removed. If the disk is removed, the surgeon may either elect to either replace, or not replace it. An rough boney surfaces are smoothed.
  • Joint replacement. If necessary, surgery can be used to replace the jaw joints with artificial implants. This is a major surgery and should be reserved for the most disabling TMJ conditions.

 

The National Institute of Dental and Craniofacial Research (NIDCR) advises that if surgery is recommended, you get other independent opinions before proceeding.

NIDCR advises that other irreversible treatments are of little value and may not cure the problem. These include orthodontia to change the bite, restorative dentistry, and adjustment of the bite by grinding down teeth to bring the bite into balance.

Follow-up

Follow your doctor's specific instructions for taking any medication prescribed and for home care with compresses or gentle jaw exercise.

You may be instructed to follow up with a specialist such as an oral and maxillofacial surgeon, a general dentist, or a pain specialist physician.

Dentists are often the first to diagnose TMJ. They are familiar with conservative treatments. Specially trained facial pain experts can be helpful in diagnosing and treating TMJ.

Prevention

If you tend to have occasional bouts with jaw pain, avoid chewing gum or biting on objects, such as pens or fingernails. Avoid eating hard or chewy food.


Previous page: TMJ Treatment
Next page: TMJ/TMD Insurance Coverage