Many people with temporomandibular joint disorder (TMD) have symptoms that decrease following self-care TMJ home remedies. This includes massage, eating a soft diet, applying cold packs or moist heat, stretching, practicing relaxation techniques and avoiding wide yawning, singing, gum chewing and quitting bad habits.
If your symptoms do not improve with self-care, however, you may wonder what the next step is. In this article, we will focus on the preferred non-invasive treatments for TMD as well as more aggressive therapies you should consider only after all other options have been exhausted.
TMJ syndrome experts like neuromuscular dentists universally recommend proper TMJ diagnosis process and the use of conservative, reversible treatments to treat the disorder. Conservative treatments do not involve surgery and do not invade the tissues of the face, jaw or TMJ. Conservative treatment leads to shortened recovery times with reduced impact on the patient’s lifestyle. Reversible treatments do not permanently change the position or structure of the jaw or the teeth. In our exploration of the treatment options that currently exist for TMJ syndrome and it’s symptoms we will start with the most common and conservative treatments.
Non Surgical TMJ treatments
TMJ Mouth Guard:
Your dentist may recommend an oral appliance, frequently called a bite or mouth guard. This is a plastic guard that fits over your upper or lower teeth similar to what an athlete would use but custom fitted to each patient’s condition and the times of day or night that it will be most effective.
An orthotic does not always cure TMD but it can provide pain relief, discourage bad habits such as clenching, grinding or nail biting. It can also be used to help realign or adjust the jaw to its natural resting position, utilizing technology such as a t.e.n.s. machine and jaw tracking. Depending on the source of the jaw dysfunction a neuromuscular dentist may fit a patient with the following types of TMJ mouth guards, also known as an orthotic:
- Night Guard: this will assist the patient in managing bruxism, night grinding or night jaw clenching. Also recommended to reduce damage to teeth and muscle soreness from jaw tension.
- Night Oral Appliance:if you are waking up with limited jaw movement, muscle soreness and jaw pain, a dentist may fit a night oral appliance and frequently modify it to help reduce the impact and realign the jaw muscles at night .
- Day Use TMJ Mouth Guard: These can be used to combat daytime usage of the jaw that is causing tmj pain.
Many times, complaints of TMJ pain are the result of malocclusion or a bad bite If your upper and lower jaws are misaligned and you are experiencing pain as well as wear and tear on your teeth, your dentist may recommend adjustment to your bite. With a bite adjustment, your dentist carefully reshapes the biting surfaces of your teeth, eliminating f excessive pressure when you bring your teeth together. This is often recommended as a second and more permanent step to take after the use of a mouthguard has shown to lessen the symptoms associated with the TMJ disorder.
TENS Therapy for TMJ:
Short for transcutaneous electrical nerve stimulation, TENS is a painless therapy that causes your jaw and facial muscles to contract and relax in a precise sequence easing tension and eliminating toxins.
As a recommended form of non-invasive and temporary pain relief for TMD, TENS allows your jaw to settle into a comfortable, natural resting position. While TENS. therapy may r immediately reduce pain, the pain often returns due to the misalignment of the jaw. However, it is immensely useful in finding the correct alignment in order to retrain the muscles in combination with an orthotic, bite adjustments and other treatments that get the jaw muscles work together properly. To learn more about TENS therapy see our scientific TENS information article here.
Another form of temporary relief for TMD is chiropractic treatment. Chiropractic care can ease pain by correcting the misalignment between your spine and central nervous system. It also relaxes your muscles, adjusts your joints and uses specific trigger points to reposition your jaw. Chiropractic treatments can be used alone or along with other treatments. Chiropractic treatments do not need to include use of high force. Studies on the efficacy of chiropractic medicine and TMJ disorder have shown that it can help in some cases. It is best to have an understanding of the cause of TMJ pain from a neuromuscular dentist before considering this treatment.
Massage therapy can help ease the pain from a jaw injury or from arthritis. It can also temporarily relieve the muscle fatigue that results from repeatedly grinding or clenching your teeth. Treatments might include exercises to gently stretch and to strengthen jaw muscles. Find TMJj massage techniques that will assist in resolving tension and ask if there is a massage therapist in the area that is familiar with tmj massage. This can be used to assist in temporary relief of TMJ symptoms that are caused by musculoskeletal tension, muscle pain and clenching. It would not be effective in cases of internal derangement, infection or severe breakdown of the soft tissues.
Alternative TMJ Treatment Options:
Some alternative medicine techniques also may help you manage the pain of TMJ disorders such as:
- Acupuncture: An acupuncturist treats TMD pain by inserting thin needles at specific points on your body.
- Relaxation: Specific breathing techniques can help relax tense muscles in your jaw which can reduce pain.
- Biofeedback: Electronic devices are used to monitor the rigidity of certain muscles in order to better practice effective relaxation techniques.
Minimally Invasive TMJ Treatments
Botox Injections for TMJ:
If your pain is chronic and has not been relieved by the other therapies, Botox treatment may be a last resort to consider. Botox may ease the muscle and nerve pain associated with TMD. However, more clinical research is needed to confirm the connection between Botox and TMD relief. Again, consult a trained TMJ dentist to gain professional opinion.
Implants and Crowns:
If your TMJ pain is caused by an unstable bite, your dentist may recommend an implant as a last resort. A tooth implant or crown may help your upper and lower teeth come together in a more comfortable manner.
Surgical TMJ Treatments
TMJ Jaw Surgery:
Non-invasive procedures should always be tried first. However, your doctor may suggest surgery or medications if those methods do not work and you are still experiencing chronic pain or if they determine that the cause of the pain is internal derangement, severe arthritis or disc damage that cannot be fixed non invasively. Be sure to ask your doctor about the potential risks as well as the potential benefits of any surgery or medication.
Here are a few surgical procedures associated with TMD that your doctor might suggest:
- Arthrocentesis: This is a procedure that involves the insertion of small needles into the TMJ joint to irrigate the joint and to remove inflammatory debris.
- Injections: In some cases, your doctor may recommend corticosteroid injections into the joint to help ease pain.
- Arthroscopy: This involves the placement of a small thin tube (called a cannula) into the joint space. An arthroscope is then inserted and small surgical instruments are used to perform surgery.
- Modified condylotomy: This surgical procedure creates a vertical cut in the mandible and is performed through the mouth, behind the molar teeth to decrease tension in the jaw.
- Open-joint surgery: This is known as arthrotomy which is designed to repair or replace the temporomandibular joint.
There is much more information in our interview with LVI clinical director Mark Duncan; DDS regarding modified condylotomy and TMJ Jaw surgery.
Medications For TMJ Relief
Although pain medications may provide temporary relief, they also mask symptoms which makes them more difficult to recognize and treat. Over-the-counter pain medications or anti-inflammatory medications, such as ibuprofen, may provide temporary pain relief from TMD. Other medications may have negative side effects and can become addictive. It is important to always consult and listen to the advice of your physician when considering medications for management of pain and muscle tension. This should not be used as a long term solution to a chronic or inflammatory pain that can be treated non invasively.
With proper diagnosis and treatment, many TMD sufferers experience relief of their symptoms. It is important to talk with a dentist who has experience dealing with patients with TMJ disorder. For more information on finding a TMD expert in your area, please see our TMJ Dentists listings.