From the Guidelines
Treatment for temporomandibular joint (TMJ) disorders should always begin with conservative approaches, prioritizing reassurance, education, and avoidance of aggravating activities, as recommended by the most recent guidelines 1.
Conservative Management
Conservative management options include:
- Over-the-counter pain relievers like ibuprofen (400-800mg every 6-8 hours) or naproxen (220-500mg twice daily) to reduce inflammation and pain
- Applying moist heat or ice packs to the jaw for 10-15 minutes several times daily
- Practicing gentle jaw stretching exercises and avoiding extreme jaw movements, hard foods, and habits like teeth grinding or jaw clenching
- A soft diet to reduce strain on the TMJ
- Dental splint or mouthguard for nighttime teeth grinding, as recommended by a dentist
- Physical therapy focusing on jaw exercises to improve mobility and reduce pain
Additional Therapies
Additional therapies that may be beneficial include:
- Physiotherapy, which can be extrapolated from its use in related conditions like other temporomandibular dysfunctions 1
- Occlusal splints, which have shown significant improvement in JIA-related orofacial dysfunction and symptoms 1
- Mindfulness, yoga, meditation, acupuncture, and cognitive behavioural therapy, as suggested by recent guidelines 1
Surgical Intervention
Surgical intervention should only be considered after non-response to conservative therapy, including arthrocentesis, arthroscopy, or open surgery of the temporomandibular joint 1. It is essential to prioritize conservative approaches to reduce inflammation, relax tense muscles, and allow the joint to heal while minimizing further irritation to the affected structures.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
TMJ Treatment Options
- Pharmacologic therapies, such as nonsteroidal anti-inflammatory drugs, muscle relaxants, benzodiazepines, antidepressants, and anticonvulsants, can be used to manage mild to moderate temporomandibular joint disorder 2
- Minimally invasive injections, including botulinum toxin, corticosteroids, platelet-rich plasma, hyaluronic acid, and prolotherapy with hypertonic glucose, can also be effective in managing TMJ disorder 2
- Conservative therapies, such as appliance or intraoral splint placement, along with physical therapy, can be used to treat TMJ problems 3
Conservative Management
- Low-level laser therapy, self-exercise, and stabilization splints may be effective in improving pain and maximal mouth opening in patients with temporomandibular disorders 4
- Non-thrust mobilization and high-velocity, low amplitude thrust manipulation techniques to the TMJ and/or upper cervical articulations can be effective in reducing pain and disability 5
- Dry needling or acupuncture of the lateral pterygoid and posterior, peri-articular connective tissue can also lead to significant improvements in pain and disability in patients with TMD 5
Treatment Guidelines
- Treatment should be evidence-based and in the patient's best interests 6
- There is no one-size-fits-all approach to treating TMJ disorders, and individual patient treatment needs may vary 6
- A thorough understanding of the pathoanatomic factors that drive the underlying condition is necessary for effective management of TMD 5