management
Last edited 04/2021 and last reviewed 04/2021
Goals of the presented modalities are to:
- 1) increase mandibular range of motion,
- 2) decrease joint and masticatory muscle pain and inflammation, and
- 3) prevent further degenerative change in articulating tissues, including
direct or indirect joint damage
- generally, the signs and symptoms of TMJ disorders improve over time with or without treatment (1)
- about 50 % improve in one year and 85 % improve completely in three years
(1)
- conservative treatments (2)
- self-care practices
- these steps may be helpful in easing symptoms, such as:
- eating soft foods
- applying ice packs
- avoiding extreme jaw movements
- stress-relieving relaxation techniques for relaxing and reducing stress (3)
- practicing gentle jaw stretching and relaxing exercises
- these steps may be helpful in easing symptoms, such as:
- medications
- nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort.
- muscle relaxants
- anti-depressants
- tricyclic antidepressants can be used to treat pain (including pain from nighttime bruxism) (1)
- antidepressants that are used in chronic pain syndromes may also be helpful
- care should be taken when prescribing selective serotonin reuptake
inhibitors
- these may rarely cause bruxism (1)
- these may rarely cause bruxism (1)
- stabilization splints
- non-invasive, occlusal splints and occlusal adjustments work to
establish balance in the occlusion and TMJs (4)
- the occlusion, or bite position, is a third and important element
in the joint system and is the element often addressed by general
dentists
- ultimate goal of splints and adjustments is to minimize pain in the joint and masticatory muscles by establishing stability
- splints may be used to control bruxism, which has been associated with tooth attrition, malocclusion, myofacial pain, and masticatory muscle strain, fatigue, and fibrosis
- long-term effectiveness of this therapy remains controversial
- the occlusion, or bite position, is a third and important element
in the joint system and is the element often addressed by general
dentists
- non-invasive, occlusal splints and occlusal adjustments work to
establish balance in the occlusion and TMJs (4)
- self-care practices
- irreversible treatments (2)
- surgery
- implants
For NICE guidance regarding management of chronic pain (pain that lasts for more than 3 months) then see linked item.
Reference:
- (1) Jennifer J. Buescher. Temporomandibular Joint Disorders. Am Fam Physician 2007;76:1477-82, 1483-84.
- (2) TMJ disorders. National Institute of Dental and Craniofacial Research. National Institutes of Health.
- (3) TMJ disorders.Coping skills. Mayo Foundation for Medical Education and Research (MFMER). 1998-2008.
- (4) Murphy MK et al. Temporomandibular Joint Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies.Int J Oral Maxillofac Implants. 2013 Nov-Dec; 28(6): e393-e414.