From the Guidelines
TMJ disorders typically cause tension-type headaches that feel like a dull, aching pain or pressure around the temples, forehead, back of the head, or neck, and the best treatments include conservative approaches such as reassurance, jaw rest, avoiding irritating behaviors, heat, NSAIDs, oral appliance in the presence of bruxism, physiotherapy, pharmacotherapy, meditation/relaxation strategies, and education about sleep hygiene. The headaches associated with TMJ disorder occur because the temporomandibular joint is connected to muscles that extend to the temples and skull, creating referred pain when the joint is inflamed or the muscles are tense 1. Some key treatment options for TMJ disorder include:
- Conservative approaches like reassurance and education, avoidance of wide mouth opening or aggravating activities, soft diet, jaw exercises, massage, non-steroidal anti-inflammatory drugs (NSAIDs), heat and/or cold, bite plate in the presence of bruxism, physiotherapy, mindfulness, yoga, meditation, acupuncture, splint therapy, cognitive behavioural therapy, paracetamol, and neuromodulatory medications (eg, amitriptyline, gabapentin) 1
- Surgery should be considered only after non-response to conservative therapy, including arthrocentesis, arthroscopy, or open surgery of the temporomandibular joint 1
- First line options like analgesics, muscle relaxants, anti-inflammatory drugs, tricyclic amines, anticonvulsants, and compounded topical ointments; jaw exercises, application of superficial heat or cold, massage, manual mobilisation, ultrasound, low-intensity laser, transcutaneous electrical nerve stimulation, acupuncture, psychological, psychotherapeutic or psychiatric treatment, and stabilisation type of occlusal appliances 1 Most TMJ cases improve with conservative treatment within a few weeks to months, but persistent symptoms warrant consultation with a dentist specializing in TMJ disorders. It's essential to note that the treatment of TMJ disorder should be based on the use of conservative, reversible, and evidence-based treatment modalities, unless there are specific and justifiable indications to the contrary 1.
From the Research
Temporomandibular Joint (TMJ) Disorder and Headaches
- Temporomandibular Joint (TMJ) disorder can cause chronic headaches, as mentioned in the study 2.
- The exact type of headache caused by TMJ disorder is not specified in the provided studies, but it is known to be associated with pain and restricted jaw mobility 3.
Treatment Options for Temporomandibular Joint (TMJ) Disorder
- Conservative, non-invasive, and reversible treatment is possible and highly successful for most temporomandibular disorder patients 2.
- Treatment options include:
- Massage therapy and individually fabricated occlusal splints 4.
- Manual therapy and taping, warming/cooling of aching joints, and light and laser therapy 4.
- Pharmacotherapy, including non-steroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, muscle relaxants, antidepressants, anticonvulsants, and benzodiazepines 5.
- Intra-articular injections of substances with anti-inflammatory properties, such as betamethasone, sodium hyaluronate, or platelet-rich plasma 3.
- Surgical restoration of the joint in severe cases of temporomandibular joint degeneration 4.
Best Treatments for Temporomandibular Joint (TMJ) Disorder
- 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.
- The use of a nocturnal bite splint, combined with intra-articular injections of platelet-rich plasma, has been shown to achieve long-term success in reducing pain and increasing pain-free mouth opening 3.
- Conservative treatment, including counseling, exercises, occlusal splint therapy, massage, and manual therapy, should be considered as a first-choice therapy for TMD pain due to its low risk of side effects 4.