Temporomandibular Joint Disorders (TMD, TMJ)
If the treatments listed above don’t help, your dentist may suggest one or more of the following:
- Transcutaneous electrical nerve stimulation (TENS). This therapy uses low-level electrical currents to provide pain relief by relaxing your jaw joint and facial muscles. It can be done at the dentist's office or at home.
- Ultrasound. Deep heat applied to the joint can relieve soreness or improve mobility.
- Trigger-point injections. Pain medication or anesthesia is injected into tender facial muscles called "trigger points" to give relief.
- Radio wave therapy. Radio waves stimulate the joint, which increases blood flow and eases pain.
- Low-level laser therapy. This lowers pain and inflammation and helps you move your neck more freely and open your mouth wider.
Surgery for TMD
If other treatments can’t help you, surgery is an option. Once it’s done, it can’t be undone, so get a second or even third opinion from other dentists.
There are three types of surgery for TMD. The type you need depends on the problem.
- Arthrocentesis is used if you have no major history of TMJ but your jaws are locked. It’s a minor procedure that your dentist can do in his office. He’ll give you general anesthesia, then insert needles into the joint and wash it out. He may use a special tool to get rid of damaged tissue or dislodge a disc stuck in the joint, or to unstick the joint itself.
- Arthroscopy is surgery done with an arthroscope. This special tool has a lens and a light on it. It lets your doctor see inside your joint. You’ll get general anesthesia, then the doctor will make a small cut in front of your ear and insert the tool. It’ll be hooked up to a video screen, so he can examine your joint and the area around it. He may remove inflamed tissue or realign the disc or joint. This type of surgery, known as minimally invasive, leaves a smaller scar, has fewer complications, and requires a shorter recovery time than a major operation.
- Open-joint surgery. Depending on the cause of the TMD, arthroscopy may not be possible. You may need this type of surgery if:
- The bony structures in your jaw joint are wearing down
- You have tumors in or around the joint
- Your joint is scarred or full of bone chips
You’ll get general anesthesia, then the doctor will open up the entire area around the joint so he can get a full view and better access. You’ll need longer to heal after open-joint surgery, and there is a greater chance of scarring and nerve injury.