TMJ

Your temporomandibular joint, or TMJ, is like a hinge that connects your jawbone to your skull. It allows you to open and close your mouth.

TMJ disorders can cause pain in your jaw joint, or prevent you from moving your jaw altogether.

In this post, Dr. Rodriguez of the Pain Relief Center in Plano, Texas will describe some of the treatments for TMJ disorders. We’ll talk about some symptoms and risk factors of TMJ disorders as well.

Signs and symptoms of a TMJ disorder include:

• pain or tenderness of your jaw
• pain in one or both of the temporomandibular joints 
• aching pain in and around your ear
• difficulty chewing or pain while chewing
• aching facial pain
• locking of the joint, making it difficult to open or close your mouth

You may also hear a clicking sound or feel a grating sensation when you open your mouth or chew. However, if you don’t feel any pain and have a normal range of motion in your jaw, you probably don’t need treatment for TMJ.

Your jaw pain acts like a sliding hinge, allowing you to open and close your jaw. The bones of the joint have a cartilaginous covering with a shock-absorbing disc between them. This keeps the movement of the jaw smooth and unhindered.

Painful TMJ disorders may occur if:

• the disc erodes or moves out of its proper alignment
• arthritis occurs in the joint
• there is damage in the joint due to a blow or other impact

There are also some risk factors that make some people more likely to develop a TMJ disorder:

• various types of arthritis
• jaw injury
• long-term grinding or clenching of teeth
• certain connective tissue diseases

Most cases of a TMJ disorder are diagnosable with a jaw examination. Your doctor will examine your jaw and discuss your symptoms with you.

Your doctor will probably:

• Listen to and feel your jaw when you open and close your mouth
• Observe the range of motion in your jaw
• Press on areas around your jaw to identify sites of pain and discomfort 

If your doctor or dentist suspects a TMJ disorder, you may also need:

• Dental X-rays
• CT scan to provide detailed imagines of the bones in your jaw
• MRI to reveal problems with the joint’s disk or surrounding soft tissue

There are a variety of treatment options for TMJ, both surgical and nonsurgical. 

Nonsurgical Treatments

In some cases, a TMJ disorder will resolve on its own. But if it persists, many doctors will begin with nonsurgical treatments.

Some of these nonsurgical treatments include:

Medications 

These medications may be helpful in relieving TMJ disorder symptoms:

• Pain relievers and anti-inflammatories. If over-the-counter pain medicines don’t work for you, you may need stronger pain relievers.
• Tricyclic antidepressants. In low doses, these antidepressants can be useful for pain relief. 
• Muscle relaxants. These types of drugs can help when jaw disorders are the result of muscle spasms.

Therapies

Non Drug therapies for TMJ disorders include:

• Oral splints or mouth guards. The benefits of wearing these soft guards are not well-understood.
• Physical therapy. Along with exercises to stretch and strengthen the jaw muscles, heat, and ice on the face could help.
• Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain. This will help you avoid triggers.

Lifestyle and home remedies 

Becoming more aware of tension-related habits like clenching your jaw or chewing too hard can help relieve the symptoms of a TMJ disorder. The following tips may help you make lifestyle changes that reduce your TMJ disorder symptoms:

• Avoid overuse of jaw muscles. Eat soft foods. Cut food into small pieces. Steer clear of sticky or chewy foods.
• Stretching and massage. There are exercises that will stretch and strengthen your jaw muscles. There are also massage techniques that will help. Your doctor, dentist, or therapist can help you learn.
• Heat or cold. Applying warm, moist heat or ice to the side of your face can help alleviate pain.

Alternative Medicine

There are a variety of possible alternative treatments for TMJ disorders, including acupuncture. 

However, there is very little scientific research attached to these therapies. Some patients and some providers have experienced improvements with alternative medicine therapies.

Surgical Treatments

When other methods aren’t effective, doctors may turn to surgical treatments for TMJ disorders. Some of these surgical treatments are:

Arthrocentesis

This is a minimally invasive procedure that involves the insertion of small needles into the joint. This allows fluid to irrigate through the joint and removes debris and inflammatory byproducts.

Injections 

Some cases of TMJ disorders can resolve through corticosteroid injections. Sometimes, injections of botulinum toxin (Botox) is also helpful. 

TMJ Arthroscopy 

In some cases, arthroscopic surgery can be effective in treating various types of TMJ disorders. Your surgeon will place a small, thin tube into the joint space and insert an arthroscope. Your surgeon will use very small surgical instruments for surgery. This procedure has fewer risks and complications than open-joint surgery.

Modified Condylotomy 

This procedure addresses TMJ directly. A surgeon performs this procedure on the mandible, but not on the TMJ itself. 

Open-Joint Surgery

If other methods don’t resolve jaw pain, this method can help solve structural problems within the joint. However, this procedure has the risk of complications.

You should only consider open-joint surgery if you have not had success with other methods, and after talking with your doctor.