Popular TMJ Treatments and Their Indications
TMJ Disorder
The temporomandibular joint (TMJ) is the joint on each side of the face that connects the lower jaw to the temporal bone of the skull below the ear. This is a highly movable joint that is involved in daily activities like talking, yawning, chewing and biting. Anatomically, the joint includes the bony mandible, and the cartilages, ligaments, muscles, nerves and blood vessels around it.
TMJ disorder usually arises from trauma, infection or degenerative changes involving the joint. Constant teeth grinding, chewing gum, biting nails or clenching teeth due to stress also predispose one to this condition. More women than men are affected, mostly between 20-50 years of age. Many of these women are also suffering from fibromyalgia.
TMJ disorder may involve one or both sides of the jaw. Symptoms include:
- Jaw pain
- Difficulty in chewing
- Lock jaw
- Clicking, grating and popping sounds in the jaw
- Neck, shoulder, face, scalp pain
- Face, mouth and jaw swelling
- Headaches, dizziness
- Ear pain, ringing in the ear, hearing loss
Popular TMJ Treatments
Early treatment with rest from constant chewing and jaw opening usually relieves jaw pain within two weeks. Avoiding chewing gum or hard candy and eating a soft diet help in reducing jaw movements from chewing.
Symptoms of pain and swelling may be treated with over the counter analgesics and nonsteroidal anti-inflammatory drugs like ibuprofen and acetaminophen. Application of a warm compress over the painful jaw for 20 minutes a day also relieves these symptoms.
Opening the mouth wide should be avoided. After applying a warm compress, gentle jaw opening exercises may be done three to five times a day for two weeks to strengthen the jaw muscles and increase mobility of the joint.
In cases where simple conservative remedies do not relieve symptoms, other TMJ treatments include:
- Medications – orally taken muscle relaxants, antidepressants, anticonvulsants; these are important especially if TMJ is associated with fibromyalgia
- Injectable steroids, local anesthetics or pain medication
- Stabilization splints – consist of oral appliances or bite guards recommended by dentists or oral surgeons; these are not permanent treatments but can relieve pain and prevent dental damage.
- Botox – becoming a popular treatment for many spastic disorders, Botox has not been approved for TMJ although research is currently being done for this condition
- Surgery – to repair anatomical defects like arthritic changes or place artificial implants to replace defective jaw joint
- Dental work like orthodontics and orthotics which aim to improve the bite
- Dental and surgical treatments are permanent and not often advised unless there are enough indications. Only one percent of patients suffering TMJ disorders will need joint replacement surgery.
- Since many women who are afflicted with TMJ are also suffering from stress related symptoms, reducing stress with relaxation techniques will significantly help in preventing muscle spasm and jaw pain.
Early conservative therapy usually relieves symptoms of TMJ within a couple of weeks. However, in the presence of anatomical defects like calcification and joint degeneration treatment may involve surgical intervention. Furthermore, when TMJ is associated with more serious manifestations of fibromyalgia, medical prescriptions for more potent drugs may be required.
References
eMedicine, “Temporomandibular Joint (TMJ) Syndrome”, https://www.emedicinehealth.com/temporomandibular_joint_tmj_syndrome/page6_em.htm
