Despite what many people think, TMJ is not a disease or a condition. It is a joint that holds your upper and lower jaw together. When this joint is damaged or somehow misaligned, it can cause jaw pain, headaches, neck pain and more. The condition is appropriately called TMD or temporomandibular joint disease because it mainly affects your TMJ. There are some ways you can ease the jaw pain and symptoms of TMD. These include:
- Moist heat from a heat pack or hot water bottle wrapped in a warm, moist towel, which can improve function and reduce pain
- Ice or ice pack to relieve pain and swelling
- Soft diet with easy-to-chew foods
- Over-the-counter analgesics
- Relaxation techniques (yoga, biofeedback, etc.)
- Relaxing facial muscles
- Jaw exercises
- Side sleeping
During your physical exam, your dentist will:
- Listen and feel your jaw as you open/close your mouth
- Check your jaw’s range of motion
- Press around your jaw to identify areas of pain or discomfort
If your dentist suspects a problem, you may need dental X-rays or a CT scan for detailed images of the bones involved in the joint, or an MRI for revealing problems with the joint’s disc.
We sometimes use TMJ arthroscopy to diagnose a TMJ disorder. During TMJ arthroscopy, we insert a small thin tube into the joint space with a small camera to view the area and help make a diagnosis.
In some cases, TMJ symptoms go away without treatment. But if your symptoms persist, your dentist may recommend one of several treatment options. Often, he will recommend that more than one treatment be done at the same time.
Combined with other nonsurgical treatments, medications may help relieve the pain from a TMJ disorder. If OTC pain relievers and anti-inflammatories don’t relieve TMJ pain, your dentist may prescribe a stronger pain reliever. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) are common treatments. We sometimes use antidepressants such as amitriptyline for pain relief. Muscle relaxants can also be used for a few days or weeks to help relieve pain from TMJ disorders.
Nondrug therapies for TMJ disorders include:
Oral splints or mouth guards can benefit people with jaw pain. Wearing a soft or firm device over the teeth can help.
Physical therapy treatments include ultrasound, moist heat, ice, and gentle exercises to strengthen your jaw muscles.
Education and counseling can help you understand which actions may aggravate your pain, such as teeth clenching or grinding, holding a phone in the crook of your neck, leaning on your chin, chewing pencils and ice cubes or biting your fingernails.
Surgical procedures that your dentist might suggest include arthrocentesis, a minimally invasive procedure that involves irrigating the joint to remove debris and inflammatory byproducts.
Corticosteroid injections into the joint may help some people. Even Botox injected into jaw muscles used for chewing may relieve pain from TMJ disorders.
TMJ arthroscopy can be as effective for treating various TMJ disorders as open-joint surgery. With an arthroscope inserted, we can use small surgical instruments for surgery. TMJ arthroscopy has fewer risks and complications.
Modified condylotomy addresses TMJ indirectly, with surgery on the mandible. This may be helpful for treatment of pain when your experience locking.
Open-joint surgery may be necessary If your jaw pain does not subside from conservative treatments and you have a structural problem in the jaw joint. Your dentist may suggest arthrotomy to repair or replace the TMJ joint. Keep in mind that open-joint surgery has greater risks than other procedures. You should discuss the pros and cons of any TMJ surgery with your dentist.
Home TMJ Remedies and Lifestyle Changes
If you have TMJ-related pain or symptoms, you should avoid habits such as clenching your jaw, grinding your teeth and chewing pencils or other items when you are stressed. This will help reduce your symptoms. To reduce symptoms of TMJ disorders, you should:
- Avoid overuse of jaw muscles
- Eat soft foods (yogurt, pasta, soup, etc.)
- Cut food into small pieces
- Avoid sticky, chewy food
- Avoid chewing gum
- Stretch and massage your jaw muscles
- Exercise to stretch and strengthen your jaw muscles (your dentist can show you how)
- Apply heat or cold (moist heat or ice) to the side of your face to reduce pain
Alternative medicine treatments can help you manage chronic pain often associated with TMJ disorders. Examples include:
- Relaxation techniques that consciously slow breathing and allow you to breathe deeply can relax tense muscles and reduce your pain
- Biofeedback, which uses electronic devices to monitor specific muscles and can help you practice more effective relaxation techniques
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