TMJ/TMD Treatment

Self-Care at Home

Many people, more women than men, have TMJ syndrome. However, the full TMJ disorder develops in only a few. Most of the symptoms disappear in two weeks because your jaw joint rests and recovers when you are unable to chew.

• Anti-inflammatory pain medications
• Eat a diet of soft foods
• Apply warm compresses on the area of pain. Home therapy includes mandible (lower jaw) movements, such as opening and closing the jaw from side to side. Try this after a warm compress is applied for 20 minutes. The lower jaw movements should be repeated three to five times a day, five minutes continuous

Medical Treatment

Most cases of TMJ syndrome are temporary; thus, treatment is usually conservative.

• Early therapy starts simply with resting the jaw, using warm compresses (ice packs at first if an injury is present), and pain medication. Jaw rest can help heal temporomandibular joints. Eat soft foods. Avoid chewing gum and eating hard candy or chewy foods. Do not open your mouth wide. Your doctor may show you how to perform gentle muscle stretching and relaxation exercises. Stress-reduction techniques may help you manage stress and relax your jaw along with the rest of your body.
• The doctor may fit you with a splint or bite plate. This is a plastic guard that fits over your upper and lower teeth, much like a mouth guard in sports. The splint can help reduce clenching and teeth grinding, especially if worn at night. This will ease muscle tension. The splint should not cause or increase your pain. If it does, do not use it.
• If conservative and noninvasive techniques do not work, you may consider more invasive techniques.
• A more invasive procedure can be performed in the doctor's office or clinic under local anesthesia. This is carried out by inserting two needles in the temporomandibular joint to wash it out. One needle is connected to a syringe filled with a cleansing solution, and the fluid exits via the other syringe. This procedure can be done in the office. Most people find relief from the pain and return to almost normal. Sometimes, pain medication can be injected into the joint in a similar procedure.
• Alternatively, a simple injection of cortisone medication can be very helpful in relieving inflammation and pain.
• A last option, surgery, is often irreversible and should be avoided when possible. If necessary, surgery can be used to replace the jaw joints with artificial implants. The National Institute of Dental and Craniofacial Research (NIDCR) advises that if surgery is recommended, you seek other independent opinions before proceeding.
• NIDCR advises that other irreversible treatments are of little value and may not cure the problem. These include orthodontia to change the bite, restorative dentistry, and adjustment of the bite by grinding down teeth to bring the bite into balance.

Follow-up

• Follow your doctor's specific instructions for taking any medication prescribed and for home care with compresses or gentle jaw exercise.
• You may be instructed to follow up with a specialist such as an oral and maxillofacial surgeon, a general dentist, or a pain specialist physician. Maxillofacial surgery may be necessary when there is poor alignment of the jaw bone (mandible) with the skull bone.
• Dentists are often the first to diagnose TMJ syndrome. They are familiar with conservative treatments. Specially trained facial pain experts can be helpful in diagnosing and treating TMJ syndrome.

Prevention

• If you tend to have occasional bouts with jaw pain, avoid chewing gum or biting on objects, such as pens or fingernails. Avoid eating hard or chewy food. When you yawn, support your lower jaw with your hand.
• See your dentist if you grind your teeth at night or find yourself clenching your jaw. The dentist can make a splint for you.
  

Outlook

Most people do well with conservative therapy, such as resting the jaw or using a mouth splint. The success of treatment depends on how severe the symptoms are and how well you comply with treatment.

• Only about 1% of those with TMJ syndrome require joint replacement surgery.