It’s estimated that over ten million Americans are affected with TMJ, women more than men, and most of the time the complaints of pain, dysfunction are moderate and not long lasting. For others, TMJ is a recurring or persistent problem that needs treatment. (1)
Treatment requires an accurate diagnosis to manage the underlying condition so as to eliminate pain, restore function and return the patient to work and normal activities. It can be classified into three categories: Non-Surgical — Surgical — Self-Care Treatments.
I: NON-SURGICAL
Medications
- Analgesics: ASA; NSAIDs like Ibuprofen;
- Muscle Relaxants:
- Antidepressant Medication
- Steroids
- Narcotic Medication
Physical Therapy
- Jaw exercises
- Massage
- Heat and Ice
Splints and Mouth Guards
Dentists work on your teeth to correct a bite problem by using braces, bridges or crowns. Splints and mouth guard are plastic mouthpieces that fit over your upper or lower teeth. The goal is to decrease clenching and grinding of teeth and correct malocclusion. A night guard is worn at night while you sleep, whereas splints may be worn all the time. The outcome of using splints varies from patient to patient.
Acupuncture
Studies indicate that Acupuncture may be helpful in post-operative dental pain and myofascial pain syndrome either alone or with other treatments.
Ultrasound
It can deliver heat to the joints and muscles of mastication (chewing muscles) providing relaxation and relief to the TMJ area.
Joint Manipulation, Injections and TENS
Manual manipulation has been successful in restoring function in patients, for example, with dislocated jaws. Injections with different medications have been used to neutralize “trigger points” and relieve muscle spasm. In patients with synovitis (inflammation of the lining that covers the jaw joint), injections of saline with and without medications have been placed in the jaw joint to restore mobility and relieve pain. Transcutaneous electrical nerve stimulation — “TENS” — has been helpful in some cases in controlling pain. (2)
II: SURGICAL
Preoperative
Control pain. Exhaust all nonsurgical treatments in an effort to relieve pain and restore function.
Arthroscopy
An instrument is placed in the jaw joint that allows the operator to enter, visualize, remove adhesions and clean the joint space.
Surgery
Surgery is reserved for those patients who failed non-surgical treatments and who have definite surgical indications. It’s advisable to get a second opinion if surgery is recommended (Yellow Light).
References
- NIH; National Institute of Dental and Craniofacial Research; TMJ Disorders 2007.
- Goddard, Greg DDS; Temporomandibular Disorders; Diagnosis and Treatment; McGraw Hill