TMJ disorders can cause pain and discomfort ranging from mild and infrequent to severe and constant. TMD is typically a progressive condition. Depending on the symptoms and level of pain, treatment may differ from person to person. Treatment can also be addressed through different options based on the suspected causes.
Cold and hot pack compresses: An ice pack or cold compress applied to the affected area for 15 to 20 minutes will reduce swelling and inflammation. Moist heat applied to the area between 15 to 20 minutes can also improve circulation to the area and reduce pain.
Physical Rehabilitation: The focus of physical therapy for TMD is relaxation, stretching and releasing tight jaw muscles. Your physical therapist can help you restore the natural movement of your jaw and decrease your pain.
Eat soft, small foods: Foods that don’t require much chewing due to small size or soft texture, such as soup, scrambled eggs, yogurt, beans and cooked, diced fruits and vegetables, will be easier to eat than foods that are hard, crunchy, chewy, thick or large. Salad is an example of a food that is chewy and should be avoided with a painful joint.
Medication for pain management: Over-the-counter pain relievers such as naproxen, ibuprofen and others can minimize the experience of pain and reduce inflammation. Prescription muscle relaxants will help patients to relieve pain caused by TMJ disorders. Low doses of antidepressants have also been found to reduce pain.
Oral appliances: Custom fabricated oral appliances can help reduce tension on the jaw muscles and the jaw joint. If a contributing factor is teeth grinding or clenching, a splint or night guard can be worn while sleeping. Clenching and grinding cannot be stopped but an oral appliance will help prevent tooth wear and limit pain in the jaw muscles and joint. Be aware that many different designs of splints are available. Based on your symptoms and needs an appliance should be selected for your use. Not all appliances are the same and not all night guards are going to effectively treat a TMJ disorder.
Surgical options: In some instances the severity of aTMJ disorder is so much more intrusive and painful that more invasive treatment options are required. If surgery is being considered when all other treatment options have fallen short of providing satisfactory relief, a few types of surgery may be considered:
- Arthrocentesis: This procedure 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.
- Arthroscopy: 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.
- Open-joint surgery: If arthroscopic surgery is not available for any number of reasons, the TMJ region may need to be opened to allow a surgeon full view and access to the temporomandibular joint to repair or replace the joint. Open-joint surgery involves more risks than other treatment options and should be considered very carefully.
Contact us at the Center for TMJ & Sleep Therapy for more information on TMD and what treatment options are available for your individual symptoms.
Dr. Maggan at the Center for TMJ & Sleep Therapy strongly believes in treatment using a multidisciplinary model. Many times the patient will present with symptoms that are clearly a result of a improper function of the temporomandibular joint, however the cause may be due to poor posture, bad bite, prior injuries distant from the site of where they may be experiencing pain. In these cases working in a multidisciplinary approach betters the outcome of care. This may include physical therapists, chiropractors, internal medicine, ENT, neurologist, oral surgeons, nutritionists, and certified massage therapists.
Evaluation of temporomandibular disorders begins with a thorough patient history and clinical examination. In some cases, the clinical examination findings are sufficient to allow the dentist to arrive at a preliminary diagnosis and begin conservative treatment. However, other patients will require diagnostic imaging of the TMJs in order to provide information, which is not available from the clinical examination.
Complex Motion Tomography
Panoramic and lateral cervical spine radiographs provide excellent hard tissue imaging of jaw bones, teeth, temporomandibular joints and the cervical spine. These diagnostic radiographs are taken at our office.
Magnetic Resonance Imaging
MRIs are used to view images of soft tissues including muscles and the disc of the jaw joint. The MRI views the soft tissue, such as the TMJ disc, to see if it is in the proper position as the jaw moves.
Cone Beam Computed Tomography
(CBCT) scan offers a highly detailed and a 3D image of the bones and structures around the jaw. CBCT has become increasingly important in the treatment and diagnosis of TMJ disorders.