Treatment Options for Temporomandibular Joint Disorders (TMD)

The temporomandibular joint (TMJ) is the hinge that connects the jawbones to the temporal bones of your skull. Found on both sides of the head, it consists of a ball and socket joint mechanism and is separated by a disc to cushion the movement. This joint facilitates common movements such as eating, speaking, and yawning. Any problems with the temporomandibular joint can readily cause TMD or temporomandibular joint disorder.

Temporomandibular dysfunction can include a wide set of disorders such as problems with the muscles that affect jaw movement, pain in the face around the TMJ, and problems within the joint itself. Thus, the diagnosis of a particular TMJ problem can be quite challenging to make. It has been reported that almost 33% of the population is affected by TMD at least once in their lifetimes.

What causes TMD?

Various researches have explored the factors that may potentially be responsible for the occurrence of TMD. Dentists strongly believe that the problem heavily arises from within the jaw or joint itself. Some of the common causes of TMD are:

Injury to the jaw, joint, or muscles of the head such as a heavy blow or whiplash

Grinding or clenching your teeth (bruxism)

Dislocation of the disc between the ball and socket of the joint

Stress or anxiety can cause the facial muscles to tighten and jaw to clench

Osteoarthritis or rheumatoid arthritis of the TMJ

Symptoms of TMD

TMD is a painful condition with numerous accompanying side-effects. Since the symptoms are vague, like headaches, they may often be overlooked and not linked to the joint problem. Some common symptoms of TMD are:

Pain or tenderness in the face, jaw joint area, neck, and shoulders

Pain in the face when you talk, chew, or open your mouth wide

Limited ability to open the mouth

Jaws that get “stuck” in a condition called lockjaw

Clicking, popping, or grating sounds in the jaw joint when opening or closing the mouth.

Difficulty chewing or uncomfortable bite

Swelling on the side of the face

Headaches with a pattern similar to migraines

Earaches and ringing of the ears (tinnitus)

Toothache

Lightheadedness

Treatment options for TMD

Temporomandibular joint disorders may be treated with a multidisciplinary approach. If you are suffering from TMD due to your nocturnal bruxing habits, you may find great help with palliative measures such as habit cessation and cognitive behavioral therapy. TMD caused by a wide range of factors can be treated with non-surgical, and surgical methods.

PHARMACEUTICAL METHODS

In conjunction with various physical therapies, medications can help relieve the pain associated with TMJ disorders. Your pain and discomfort may be eased by some of the following medications:

Analgesics and anti-inflammatories: Over-the-counter pain relievers such as non-steroidal anti-inflammatory steroids (NSAIDs) can help relieve much of the TMD pain. In cases where pain does not subside, your dentist may prescribe you with a higher dose of pain killers.

Tricyclic anti-depressants: Medications like these are mostly prescribed for depression but in low doses can sometimes be used for pain relief, bruxism cessation, and sleeplessness.

Muscle relaxants: These drugs are used for a few days or weeks to help relieve pain caused by TMD. Research has shown that muscle relaxant therapies significantly help control muscle spasms associated with TMD.

NON-PHARMACEUTICAL METHODS

Other therapies for TMD may include:

Oral splints or mouth guards: Mouth guards are first-line-action methods to treat bruxism. If you are consistently engaging in teeth grinding and clenching, your dentist will prescribe you with splints or other occlusal appliances that interfere with the unnatural contact and movement between the upper and lower teeth. Once bruxism is under control, the pain and discomfort with TMD are also reduced.

Physical therapy: The American Academy of Family Physicians believes that some physical exercises help relieve TMD pain and improve jaw movement. Exercises to stretch and strengthen the jaw muscles may often be accompanied by ultrasound or moist heat and ice.

Biofeedback: It is a practice by which patients can be made aware of their harmful habits and subsequently stop conducting them. This therapy has found to have short-lived positive outcomes for patients with a history of teeth grinding and jaw clenching.

SURGICAL METHODS

When other methods do not help, the doctor may seek the assistance of surgery to help relieve your TMD symptoms.

Arthrocentesis: It is a minimally invasive procedure wherein the temporomandibular joint is irrigated with small needles to remove debris and inflammatory by-products. The procedure may also allow for deposition or drugs in the damaged joint. This is done for patients with internal derangement in their jaw joints.

Injections: Corticosteroid injections or more frequently botulinum toxin injections have been observed to be helpful to patients for relieving pain associated with TMD.

TMJ arthroscopy: Also known as keyhole surgery, this procedure involved the insertion of an arthroscope in the joint that allows the dentist to see inside the TMJ for any signs of damage or injury.

Open-joint surgery: This is a relatively invasive procedure that seeks to repair or replace the temporomandibular joint. It may be a choice of treatment only when all the other conservative techniques have failed.

What can you do to improve TMD?

Which other measures regular you to visit the dentist, you can also make use of some at-home remedies to ease your pain and discomfort connected with TMD.

Avoid the overuse of jaw muscles while eating

Eat soft foods, or foods cut into smaller bite-sized pieces in order to not stain the jaw

Avoid chewing gum or consuming sticky or chewy foods

Apply warm, moist heat, or ice to the side of the face to alleviate pain

Perform stretching exercises for your jaw frequently

The temporomandibular joint disorder is a musculoskeletal disorder that needs multiple sects of assistance. You need to make sure that your TMD is properly diagnosed and treated before it gets worse. Connect with your doctor to understand your treatment options to relieve temporomandibular joint disorders and their associated symptoms.

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