From the Guidelines
The recommended treatment for severe right temporomandibular joint (TMJ) degeneration is to start with 500mg of Acetaminophen (Tylenol) every 6-8 hours, up to a maximum of 4g daily, as supported by the North of England Non-Steroidal Anti-Inflammatory Drug Guideline Development Group 1. When managing pain associated with TMJ degeneration, it is essential to combine medication with non-medication approaches, including:
- Applying moist heat to the affected area for 20 minutes several times daily
- Eating soft foods
- Avoiding extreme jaw movements like wide yawning or gum chewing
- Practicing gentle jaw stretching exercises It is crucial not to exceed 3,000mg of acetaminophen in a 24-hour period to avoid liver damage. If pain persists after 7-10 days of consistent acetaminophen use, consultation with a healthcare provider is necessary to consider additional treatments such as prescription-strength anti-inflammatories, muscle relaxants, or a custom dental splint, as acetaminophen does not reduce inflammation 1. The treatment plan may need to be adjusted based on the patient's response to the initial treatment, and alternative drugs such as ibuprofen, diclofenac, or naproxen may be considered if relief of symptoms is still inadequate, as suggested by the guideline 1.
From the Research
Treatment Options for Severe Right Temporomandibular Joint (TMJ) Degeneration
- The use of 500mg Acetaminophen (Tylenol) every 6-8 hours is a common conservative treatment approach for managing pain associated with TMJ degeneration 2.
- However, for severe TMJ degeneration, more invasive treatment options may be necessary, such as temporomandibular joint replacement (TJR) or alloplastic reconstruction of the TMJ 3, 4.
- Other treatment options that have shown promise include arthrocentesis with intra-articular injections of sodium hyaluronate, which can help to reduce pain and improve joint function 5.
- A multidisciplinary team approach to management is essential in the fundamental care of all TMD patients, as treatment can be specifically tailored to individual patient needs 6.
- The treatment strategy for TMJ osteoarthritis aims at relieving pain, preventing the progression of cartilage and subchondral bone destruction, and restoring joint function, with conservative therapy being the most common treatment approach 2.
Considerations for Treatment
- The choice of treatment for severe right TMJ degeneration depends on the individual patient's needs and the severity of the condition.
- Conservative treatment options, such as medication and physical therapy, may be effective in managing symptoms, but may not address the underlying degeneration of the joint.
- More invasive treatment options, such as TJR or alloplastic reconstruction, may be necessary to restore joint function and alleviate pain, but carry risks and complications, such as infection and material hypersensitivity 3, 4.