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Treatments and drugs
By Mayo Clinic staffIn some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend medications or a bite guard to help keep you from grinding your teeth at night. In very rare cases, surgery may be required to repair or replace the joint.
Medications
- Painkillers. If over-the-counter pain medications aren't enough to relieve TMJ pain, your doctor or dentist may prescribe stronger painkillers.
- Tricyclic antidepressants. Antidepressants, such as amitriptyline or nortriptyline, taken at bedtime help relieve TMJ pain in some people.
- Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.
- Corticosteroid drugs. For significant pain and joint inflammation, corticosteroid drugs injected into the joint space may provide relief.
- Botulinum toxin. Injecting botulinum toxin (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.
Therapies
- Bite guard. If you grind your teeth in your sleep, you may benefit from wearing a soft or firm device inserted over your teeth. This bite guard prevents your teeth from meshing together. Bite guards sometimes aggravate sleep apnea symptoms.
- Cognitive behavioral therapy. If your symptoms of TMJ disorder are made worse by poorly managed stress or anxiety, your doctor or dentist may refer you to a psychotherapist with experience in cognitive behavioral therapy. This approach includes interventions to help you be aware of and change behaviors, learn relaxation techniques, and manage stress.
Surgical or other procedures
- Corrective dental treatment. Your dentist may improve your bite by balancing the biting surfaces of your teeth, replacing missing teeth, or replacing needed fillings or crowns. However, these types of treatments sometimes worsen TMJ pain.
- Arthrocentesis. This procedure involves insertion of a needle into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.
- Surgery. As a last resort, your doctor or dentist may suggest surgery to repair or replace the joint. But the National Institute of Dental and Craniofacial Research considers TMJ surgery to be controversial and recommends that it be avoided whenever possible.
References
- TMJ disorders. National Institute of Dental and Craniofacial Research. http://www.nidcr.nih.gov/oralhealth/topics/tmj/tmjdisorders.htm. Accessed April 1, 2010.
- TMJ. American Academy of Otolaryngology: Head and Neck Surgery. http://www.entnet.org/HealthInformation/tmj.cfm. Accessed April 6, 2010.
- Laskin DM. Temporomandibular joint disorders. In: Cummings CW, et al. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, Pa.: Mosby Elsevier; 2005. http://www.mdconsult.com/das/book/body/192497386-8/977005653/1263/625.html#4-u1.0-B0-323-01985-4..50071-X_2752. Accessed April 1, 2010.
- Sheon RP. Temporomandibular joint dysfunction syndrome. http://www.uptodate.com/home/index.html. Accessed April 5, 2010.
- Zuzek RW, et al. Temporomandibular joint syndrome. Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/193390682-3/0/2088/643.html#4-u1.0-B978-0-323-05609-0..00029-0--sc0035_13145. Accessed April 6, 2010.
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