In most cases, treatments focus on avoiding things that aggravate the TMJ and its muscles (such as chewing gum, clenching or grinding your teeth, or opening your mouth wide when you yawn). You may be given pain relievers and/or anti-inflammatories. Some tmj treatments are based on resting the jaw to let it heal. Other TMJ treatment options include bite or occlusion problems that can be corrected through orthodontics such as ClearCorrect and Invisalign, which slowly move teeth into their proper position through a series of clear aligners. Medication can also be prescribed, such as tricyclic antidepressants which are often used for depression but in low doses can help with pain relief and bruxism control.
TMJ arthroscopy (ahr-thoh-sen-TEE-sis) allows your doctor to view the jaw joint and to remove scar-like tissue and reposition the disc. This procedure can improve pain and mouth opening in about 3 weeks.
1. Physical Therapy
TMD can cause pain and stiffness that mimics chronic headaches, sinus disease or ear infections. It may also cause neck or tooth pain. These symptoms can make it difficult to figure out what is causing them.
You and your doctor will probably start by trying conservative treatments at home, such as avoiding chewing gum or hard foods, applying heat or ice to the jaw area and practicing relaxation techniques. Some people find that acupuncture can help reduce pain and relax the jaw muscles. However, evidence of its effectiveness is limited.
Some doctors recommend arthroscopy (ahr-thoe-sen-TEE-shun), in which a doctor puts a small camera into the jaw joint through an incision. This can help diagnose the problem and remove scar tissue, or dislodge a disc that is stuck in the jaw joint. It has been shown to provide some short-term relief and improve mouth opening for people with locked jaws, but it is not a permanent solution.
2. Medication
Over-the-counter pain medications such as ibuprofen (Advil) or naproxen (Aleve) can relieve jaw pain and control swelling temporarily. Your dentist may also recommend a more powerful medication to ease TMJ pain. Acetaminophen (Tylenol) is a common pain reliever, but it doesn’t treat inflammation and can cause liver problems if you take too much over time.
Centrally acting muscle relaxants such as cyclobenzaprine (Flexeril) and diazepam (Valium) have been shown to reduce TMJ pain, swelling, and spasms. Anti-anxiety drugs such as alprazolam (Xanax) and lorazepam (Ativan) can help relieve stress, which can worsen TMJ symptoms.
Your doctor may prescribe a mouth guard to prevent you from grinding your teeth during sleep (bruxism). Or, they might suggest following a soft food diet. This can decrease pressure on your jaw joint. Medications such as NSAIDs can also be used to manage pain and inflammation. They are safe if taken as directed. However, you should always exhaust all reversible remedies before considering more aggressive treatments.
3. Splints
A splint is a removable oral appliance that covers one or more upper or lower teeth to reduce clenching and grinding, or to shift your jaw into a healthier position. Splints are typically worn at night, but they can also be worn during the day to help manage pain and inflammation.
When splint therapy is used, we will schedule regular appointments to check your progress and readjust the splint if needed. This helps ensure that your bite and jaw movements improve over time.
Symptoms include pain in the face or neck, clicking or popping sounds in the joints, trouble opening and closing your mouth, a ringing in the ears, headaches/migraines, dizziness or vertigo, numbness in the fingers, and poor posture. Your doctor may recommend splint therapy in combination with other treatments, such as physical therapy or medication. They might also suggest repositioning appliances or orthodontic treatment like braces or clear aligners to address crooked teeth or a misaligned bite that contribute to clenching and grinding.
4. Surgery
The TMJ is a complex anatomical structure including muscles, ligaments, tendons, bones and blood vessels. Because of this, TMD symptoms can be very difficult to diagnose.
Symptoms can include pain in the chewing muscles or jaw, limited movement of the jaw, clicking, popping, grating, or locking of the jaw joint, neck aches or headaches, and ringing in the ears. These symptoms may be present on one or both sides of the face and can spread to other parts of the head and neck.