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TMJ (Temporomandibular Joint Disorders)

Treatment

In some cases, TMJ disorders can go away without treatment. However, if your symptoms persist, we may recommend a variety of treatment options, often more than one to be done at the same time.

Medication Options

OTC or over the counter pain relievers and anti-inflammatories typically relieve TMJ pain. We can check with your primary in severe cases if stronger non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others), aren’t enough.

Muscle relaxants

These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.

Therapies

Nondrug therapies for TMJ disorder include:

  • Oral splints or mouth guards (occlusal appliances). Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well-understood.

  • Physical therapy. Treatments might include ultrasound, moist heat and ice — along with exercises to stretch and strengthen jaw muscles.

  • Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails.

Surgical Procedures

When a common approach method doesn’t help, we might suggest procedures such as:

Arthrocentesis (ahr-throe-sen-TEE-sis) is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.

Injections. In some people, corticosteroid injections into the joint may be helpful. Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.

TMJ Arthroscopy

In some cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted, and small surgical instruments are used for surgery. TMJ arthroscopy has fewer risks and complications than open-joint surgery does, but it has some limitations as well.

Modified Condylotomy

Modified condylotomy (kon-dih-LOT-uh-mee) addresses the TMJ indirectly, with surgery on the mandible, but not in the joint itself. It may be helpful for treatment of pain and if locking is experienced.

Open-joint Surgery

If your jaw pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, your doctor or dentist may suggest open-joint surgery (arthrotomy) to repair or replace the joint. However, open-joint surgery involves more risks than other procedures do and should be considered very carefully, discussing the pros and cons.

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