From the Guidelines
Treatment options for TMJ disorder should begin with conservative approaches, prioritizing self-care measures, physical therapy, and reversible interventions, before considering more invasive interventions, as recommended by the most recent clinical practice guideline 1. The initial treatment includes self-care measures such as eating soft foods, avoiding extreme jaw movements, applying ice or heat packs, and practicing gentle jaw stretching exercises.
- Over-the-counter pain medications like ibuprofen (400-800mg every 6-8 hours) or naproxen (220-500mg twice daily) can help reduce inflammation and pain.
- Muscle relaxants such as cyclobenzaprine (5-10mg at bedtime) may be prescribed for short-term use to relieve muscle spasms.
- Physical therapy focusing on jaw exercises and proper posture can improve jaw function and reduce pain.
- Oral splints or night guards custom-fitted by dentists help prevent teeth grinding and reduce pressure on the joint. For persistent cases,
- cognitive behavioural therapy (CBT) with or without biofeedback or relaxation therapy,
- therapist-assisted mobilisation,
- manual trigger point therapy,
- supervised postural exercise,
- supervised jaw exercise and stretching with or without manual trigger point therapy, are strongly recommended 1. Surgery is reserved for severe cases that don't respond to other treatments and may include arthrocentesis (joint fluid removal), arthroscopy, or open-joint surgery, as a last resort, considering the potential risks and complications, such as infection, as reported in recent studies 1. It is essential to note that
- irreversible oral splints,
- discectomy,
- NSAIDS with opioids, are strongly recommended against due to the potential harm and lack of evidence supporting their effectiveness 1. In contrast,
- acupuncture,
- manipulation,
- supervised jaw exercise with mobilisation,
- CBT with non-steroidal anti-inflammatory drugs (NSAIDS), are conditionally recommended, considering the moderate certainty of evidence supporting their use 1. Ultimately, the treatment plan should be individualized, taking into account the patient's specific needs, preferences, and medical history, to optimize outcomes and minimize risks, as emphasized in recent clinical practice guidelines 1.
From the Research
Treatment Options for Temporomandibular Joint (TMJ) Disorder
The treatment options for Temporomandibular Joint (TMJ) disorder can be categorized into conservative and surgical approaches.
- Conservative treatment options include:
- Patient education
- Home-care plan
- Biobehavioral therapy
- Physical therapy
- Orthotic jaw appliance therapy
- Pharmacotherapy 2
- Surgical treatment options include temporomandibular joint total joint replacement (TMJR) 3
Non-Invasive Treatment Modalities
Non-invasive treatment modalities for TMJ disorders are the initial treatment approach and include:
- Chiropractic therapy, which has shown promising results in managing TMD symptoms 4
- Non-invasive different modalities of treatment, such as oral rehabilitation, physical therapy, and medication 5
Multidisciplinary Team Approach
A multidisciplinary team approach to management is essential in the fundamental care of all TMD patients, allowing treatment to be specifically tailored to individual patient needs 6
Treatment Goals
The goal of treatment for TMJ disorders is to increase function, reduce pain, and improve quality of life 2