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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
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as aspirin or ibuprofen, usually don't provide enough relief for pain caused by TMJ disorders. However, there's some evidence that naproxen (Aleve, others) may be helpful if combined with exercises designed to stretch jaw muscles.
- Tricyclic antidepressants. Antidepressants, such as amitriptyline or nortriptyline, taken at bedtime have proved effective in relieving TMJ pain.
- Muscle relaxants. Drugs, such as carisoprodol (Soma, others), may be used for a few days or weeks to help relieve pain caused by TMJ disorders. These drugs can be habit-forming and should be withdrawn gradually.
- Corticosteroid drugs. For significant pain and joint inflammation, corticosteroid drugs injected into the joint space may provide relief.
- Botulism toxin. Injecting botulism toxin (Botox, others) into the jaw muscles used for chewing has relieved 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.
- 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. If the other approaches don't work, your doctor or dentist may refer you to an oral and maxillofacial surgeon. Surgery to repair or remove the disk between your mandible and temporal bone may be beneficial. When advanced osteoarthritis is present, a partial or total joint replacement may help remove bone-on-bone contact and improve joint mechanics and motion.
