Treatments for TMJ

Treatments for TMJ (temporomandibular joint) vary based on the cause of your symptoms. TMJ can be a medical problem if it is caused by pain in the facial area or the jaw joint. It can also be a dental problem if the pain is caused by your teeth or an issue with your mouth.

TMJ is often a short-term problem that lasts no longer than three weeks. First-line treatments include over-the-counter drugs and lifestyle changes. Stronger drugs and special treatments are often reserved for longer, more severe cases.

This article describes treatment for TMJ, including home remedies and lifestyle changes. lt also describes TMJ treatments using drugs, surgery, special treatments, and alternate treatments.

Treatments for TMJ At Home

Many cases of TMJ pain can be reduced with the following home remedies and lifestyle changes:

Hot and cold compress: A hot compress can increase blood flow and relax your jaw muscles. A cold compress reduces swelling and pain. To reduce pain, apply a hot or cold compress to your jaw for 15 to 20 minutes at a time. Protect your skin by placing a light layer of cloth between your skin and the compress.

Reduce bad habits: Some habits can increase your risk of developing TMJ pain. If you're routinely doing any of the following habits, work to correct your actions:

• Nail biting
• Resting your jaw in your hand
• Clenching your teeth
• Grinding your teeth
• Chewing your cheeks and lips
• Clenching your jaw muscles while pushing the tongue against your teeth
• Yawning
• Chewing gum

Jaw exercises: Jaw exercises are considered among the first-line treatments for TMJ disorders. The following types of jaw exercises may help relieve symptoms:

• Jaw-strengthening exercises to build strength and endurance
• Jaw-stretching exercises to help extend the soft tissue around the jaw muscles to increase the range motion of the jaw
• Postural exercises to improve faulty posture that can cause your lower jaw to protrude forward and create a bad bite
  

Soft food diet: A soft food diet with foods like applesauce, yogurt, and mashed potatoes can decrease pain and discomfort by reducing stress on the jaw joints while you chew. This allows your jaw joints and muscles to relax so you can heal faster.

Following a soft food diet excludes eating hard, chewy, and crunchy foods like nuts, pretzels, and carrots. When eating hard foods, cutting them into smaller pieces makes them easier to eat and avoids the need to open your mouth widely.

Over-the-Counter (OTC) Treatments for TMJ

OTC therapies are the first-line treatment for most cases of TMJ pain. One of the most popular OTC medications for TMJ is Tylenol (acetaminophen), which temporarily reduces jaw pain.

OTC nonsteroidal anti-inflammatory drugs (NSAIDs) are also helpful in treating TMJ. These drugs address multiple symptoms by effectively decreasing pain, controlling swelling, and reducing inflammation.

The following OTC NSAIDs are advised for treating TMJ:

• Bayer, Ecotrin, Bufferin (aspirin)
• Motrin, Advil (ibuprofen)
• Aleve, Naproxen (naproxen)

Prescriptions for TMJ

Several classes of prescription drugs are used to treat TMJ pain. These drugs include the following:

Prescription NSAIDs: Prescription NSAIDs provide similar pain-relieving and anti-inflammatory benefits as OTC NSAIDs, though in stronger formulations. These drugs include:

• Celebrex (celecoxib)
• Indocin (indomethacin)
• Mobic (meloxicam)

Antidepressants: Antidepressants influence how your body interprets pain. The following antidepressants can be prescribed for chronic TMJ pain:

• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)
• Elavil (amitryptyline)

Anticonvulsants: Anticonvulsants often treat nerve pain in chronic pain disorders like TMJ. The following anticonvulsants are used to treat TMJ:

• Lyrica (pregabalin)
• Neurontin (gabapentin)
  

Muscle relaxants: Muscle relaxants relieve jaw pain and discomfort by relaxing the muscles in your face and jaw. They also help reduce muscle spasms. Examples of muscle relaxants used to treat TMJ include:

• Flexeril (cyclobenzaprine)
• Robaxin (methocarbamol)
• Skelaxin (metaxalone)
  

Physical Therapy for TMJ

Depending on the cause of your TMJ pain, you may benefit from physical therapy.

Physical therapy can often help decrease pain and restore normal jaw function. A physical therapist designs an individualized treatment plan for your condition and its causes. This usually includes the following components:

• Education on proper tongue-resting position, posture, body mechanics, and self-management
• Treatment modalities to prepare your soft tissue for manual therapy, including heat or ice, electrical stimulation, ultrasound, or light therapy
• Soft-tissue release involving hands-on treatments on your face, jaw, and the inside of your mouth to address muscle tightness and spasms
• Mobilization of the TMJ to loosen stiffness in your neck and jaw and restore normal TMJ movement
• Therapeutic exercises to perform on your own throughout the day to improve joint mobility and maintain proper head, neck, and jaw alignment

Other types of physical therapy treatment for TMJ include:

• Ultrasound: Ultrasound therapy uses high-frequency sound waves directed to the TMJ. This treatment can help improve TMJ functionality and mouth opening limit. It can also reduce pain and swelling.
• Transcutaneous electrical nerve stimulation (TENS): TENS uses a battery-operated device that sends low-voltage electrical currents through adhesive electrodes attached to the skin. The electrodes are placed over the nerves where pain occurs or at trigger points for pain, such as in the neck or jaw. The treatment sends a series of impulses to stimulate the trigger points.

Dental Treatments for TMJ

If you see a dentist to help treat your TMJ, you may be fitted for an oral splint.

An oral splint is a removable dental appliance that covers several or all of your upper or lower teeth. The splint is manufactured in a dental lab from an impression of your mouth. It is made of hard acrylic resin and individualized for your needs.

There are many different types of splints. They vary in their purpose and the portion of your mouth they cover. An oral splint can do the following:

• Provide relief from pain by improving jaw function so it can move smoothly
• Produce changes in your bite and jaw positioning in preparation for a major dental treatment such as orthodontics to establish a new position for your jaw

Procedures and Surgeries for TMJ

The following procedures and surgeries may be used to treat TMJ:

TMJ joint injection: A TMJ joint injection is the administration of an injection into the affected TMJ. A TMJ joint injection is offered after self-treatment or conservative treatments fail to produce improvement. The effect of the joint injection can temporarily improve mouth-opening capacity so you can perform jaw exercises without pain. The contents of the injection can include the following, based on your needs:

• Lidocaine to reduce injection pain
• Corticosteroids to reduce inflammation
• Hyalgan (sodium hyaluronate) to lubricate and reduce TMJ friction
• Botox (onabotulinumtoxinA) to relieve tight muscles

Arthrocentesis: Arthrocentesis, also called joint aspiration, is the least invasive type of TMJ surgery. It involves using a needle to drain fluid from a joint for diagnosis or to relieve pressure. In some cases, a saline solution is injected into the joint to cleanse it of debris and inflammatory byproducts. After the initial treatment, a corticosteroid, joint lubricant, or other substance can be injected into the joint using the same injection site used for the first part of the procedure.

Arthroscopy: TMJ arthroscopic surgery involves inserting an instrument into your jaw joint through a small cut. A camera is connected to the end of the tube to look inside your TMJ joint to see what may be causing your TMJ problems. Depending on the cause of your symptoms, your surgeon can use small surgical instruments to repair your TMJ by removing scar tissue, repositioning the disc, or removing bone spurs as needed.

Open-joint surgery (arthrotomy): Open-joint surgery involves making an incision along your ear to expose the TMJ joint. It can involve one or both of the following options:

• Arthroplasty: Arthroplasty is an open-joint procedure used to remove bone spurs, adhesions, and other jaw growths causing joint pain and dysfunction.
• Disc surgery: When the joint disc is causing your problems, open-joint surgery may be needed to perform a disc plication (repositioning the disc), discectomy (removal of the disc), or replacement of the disc.

Joint replacement: TMJ joint replacement is commonly called total temporomandibular joint replacement (TMJR). It is used to treat a severe TMJ disorder causing severe pain or limited jaw function that has not responded to other types of treatment. TMJ joint replacement involves the surgical placement of implants for all or part of the TMJ.

Complementary and Alternative Medicine (CAM) for TMJ

CAM treatments for TMJ pain can be used in conjunction with conventional medical and dental approaches to reduce pain and stress. They can also be valuable options when certain treatments are contraindicated for your condition.

CAM treatments used for TMJ include the following:

Acupuncture: Acupuncture is part of the healing system used in traditional Chinese medicine. It involves the insertion of hair-thin needles at specific points in the skin. Stimulating these points triggers reactions from certain tissues, glands, and bodily functions that coordinate with the locations.

Stress management: Stress management techniques can help you control your stress, which may trigger jaw clenching and TMJ symptoms. These techniques can include the following:

• Deep breathing
• Guided imagery
• Meditation
• Yoga poses
  

Red-light therapy: Red-light therapy uses light-emitting diodes (LEDs) to send low-intensity infrared and near-infrared light deep into your body's cells. It is a form of photodynamic therapy that promotes healing. Red light therapy can increase the range of motion for your TMJ, relieve pain, and improve muscle activity.

Summary

There is a range of options for treating TMJ (temporomandibular joint) dysfunction. There are multiple factors to consider when deciding on a treatment course.

Most cases of TMJ are short-term and often resolve on their own or with at-home treatments like hot and cold packs, over-the-counter medications, diet and lifestyle changes.

For more severe or unresolved TMJ, treatments like prescription medication, dental appliances, and physical therapy may be warranted. Surgical interventions are an option but are rarely needed for TMJ.