TMJ Treatments

We don't know for certain how many people have TMJ disorders, but some estimates suggest that over 10 million Americans are affected. The condition appears to be more common in women than men.

For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.

The temporomandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head—the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joints. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint control its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the jaw joint from chewing and other movements.

The temporomandibular joint is different from the body's other joints. The combination of hinge and sliding motions makes this joint among the most complicated in the body. Also, the tissues that make up the temporomandibular joint differ from other load-bearing joints, like the knee or hip. Because of its complex movement and unique makeup, the jaw joint and its controlling muscles can pose a tremendous challenge to both patients and health care providers when problems arise.

What are TMJ disorders?

Disorders of the jaw joint and chewing muscles—and how people respond to them—vary widely. Researchers generally agree that the conditions fall into three main categories:

Myofascial pain, the most common temporomandibular disorder, involves discomfort or pain in the muscles that control jaw function.

Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.
Arthritis refers to a group of degenerative/inflammatory joint disorders that can affect the temporomandibular joint.

How jaw joint and muscle disorders progress is not clear. Symptoms worsen and ease over time, but what uses these changes is not known. Most people have relatively mild forms of the disorder. Their symptoms improve significantly, or disappear spontaneously, within weeks or months. For others, the condition uses long-term, persistent and debilitating pain.

A variety of symptoms may be linked to TMJ disorders. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom. Other likely symptoms include:

• radiating pain in the face, jaw, or neck
• jaw muscle stiffness
• limited movement or locking of the jaw
• painful clicking, popping or grating in the jaw joint when opening or closing the mouth, a change in the way the upper and lower teeth fit together.

How are TMJ disorders diagnosed?

There is no widely accepted, standard test now available to correctly diagnose TMJ disorders. Because the exact uses and symptoms are not clear, identifying these disorders can be difficult. You may want to consult your doctor to rule out known uses of pain. Facial pain can be a symptom of many other conditions, such as sinus or ear infections, various types of headaches, and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.

How are TMJ disorders treated?

Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment.

Conservative Treatments

Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment is all that is usually needed to relieve discomfort.

Self-Care Practices

There are steps you can take that may be helpful in easing symptoms, such as:

• eating soft foods
• applying ice packs
• avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing),
  learning techniques for relaxing and reducing stress, practicing gentle jaw stretching and relaxing exercises that may help increase jaw movement. Your health re provider or a physical therapist can recommend exercises if appropriate for your particular condition.

Pain Medications

For many people with TMJ disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, your dentist or doctor can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or anti-depressants to help ease symptoms.

Stabilization Splints

Your doctor or dentist may recommend an oral appliance, also called a stabilization splint or bite guard, which is a plastic guard that fits over the upper or lower teeth. Stabilization splints are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. If a stabilization splint is recommended, it should be used only for a short time and should not use permanent changes in the bite. If a splint uses or increases pain, stop using it and see your health re provider.

The conservative, reversible treatments described are useful for temporary relief of pain – they are not cures for TMJ disorders. If symptoms continue over time, come back often, or worsen, tell your doctor.