Dealing with TMJ Disorders
Your treatment options if you have Temporomandibular Disorders
Two Categories of TMD Patients
The large majority of temporomandibular disorders stem from jaw muscle problems that cause pain and tightness. “Luckily, most... are muscle spasm problems,” Messina says.
In contrast, only a small minority of cases stem from problems within the jaw joint itself, he says. These include a disk that moves out of proper position, strained ligaments, osteoarthritis, and other joint-related conditions, Messina says.
“If we’re concerned that there’s an internal problem in the joint itself, the patient may be recommended to have either an MRI or a CAT scan of the joint,” he says.
Fortunately, Messina says, “the vast majority of [TMD] will not require surgical intervention.”
Instead, most patients can try nonsurgical treatments, which don’t cure TMD, but help to relieve pain and improve function. Experts tell WebMD that it’s crucial to try these methods before resorting to surgery or other treatments that result in permanent changes to the jaw or teeth.
Nonsurgical treatments include:
Stabilization or bite splint: This main treatment for jaw muscle pain and tightness involves using a plastic guard that fits over the upper or lower teeth. “It allows the teeth to slide smoothly against each other, which lets the jaw muscles relax,” Messina says. Splinting helps to prevent clenching and grinding of the teeth. Most people wear the splint only at night, but in severe cases, Messina says, “the patient may be wearing the splint 24 hours a day, except when they’re eating.”
Physical therapy: “Physical therapy involves muscle relaxation and increasing the range of motion in the joint,” Messina says. These methods may include biofeedback, stretching exercises, or ultrasound treatments. Applying warm compresses to the side of the face during exercises may be useful, too, Messina says.
Yoga, meditation, acupuncture, and stress management can also help ease symptoms, Messina says. “Stress doesn’t cause [TMD], but it certainly makes it worse,” he says.
Richard Ohrbach, DDS, PhD, is a dentist and a clinical psychologist. Among his treatments for TMD, he teaches some patients relaxation skills to help them cope with pain. “Patients just benefit from learning how to really relax their bodies,” says Ohrbach, who is also an associate professor of oral diagnostic sciences at the University at Buffalo.
Drug therapy: These treatments include anti-inflammatory medications to relieve pain and prescription muscle relaxants. “If there are some severely inflamed muscles that have restricted motion because they’re in spasm -- the muscles are excessively contracted or hyperactive -- we can use some muscle relaxants,” Messina says.
Comparing Nonsurgical and Surgical Treatments
Experts agree that nonsurgical treatments should be tried first -- unless there’s a compelling reason for immediate surgery, such as a tumor in the jaw joint.
Temporomandibular joint surgeries carry risks, Messina says. “Post-surgically, some pain in the joint tends to be fairly common.” Other surgical complications include nerve damage, bleeding, infection, and scarring of the joint.