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Other Treatments for Temporomandibular Disorders

For Managing Pain and Inflammation

Application of Heat and Cold

Heat improves blood circulation to the treated area. Applying heat via warm soaks or heating pads can be very soothing and may relax muscle spasm. Most doctors recommend that you apply the heat for about 10 minutes at a time, 3-4 times a day.

Cold can help decrease inflammation in an affected joint, relieve pain, and improve stiffness and movement. Apply an ice pack for 20-30 minutes at a time, several times each day.

Intra-articular Corticosteroid Injections

Corticosteroid injections are rarely used for TMD, although they may be recommended for more severe cases, predominantly when the disorder is caused by inflammatory conditions, such as rheumatoid or osteoarthritis. The corticosteroid medication can help decrease inflammation and pain in the joint.

In this therapy, the affected joint is injected with a solution containing a corticosteroid, such as:

  • Methylprednisolone
  • Triamcinolone

Laser Therapy

There is some limited evidence that low-level laser therapy can improve symptoms, though few scientific studies provide strong guidance for choosing treatments.

For Managing Tooth Grinding and Jaw Clenching

Splint, Bite Plate, Nightguard

You doctor may order you a splint or bite plate that interferes with jaw clenching and teeth grinding. You might be advised to wear it only at night, or you might wear it at times during the day when you are more likely to grind your teeth or clench your jaw. These appliances should not alter your natural bite.

Botox

In the more common situation in which pain is due to muscle tension rather than TMD arthritis, injection of botox into facial muscles can give relief of pain when other treatments have failed. It can weaken the muscles that cause jaw clenching.

Treatments may need to be repeated. The safety and efficacy of such repeated treatments have not yet been established.

For improving function

Physical therapy

Exercises may help to strengthen your jaw muscles.

Gentle jaw stretching and relaxing exercises may help increase jaw movement.

When to Contact Your Doctor

Contact your doctor if:

  • The device or treatment seems to be increasing your pain.
  • You notice any new symptoms after you begin using the appliance or treatment.

Revision Information

  • Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain. 2002;3(1):21-27.

  • Cetiner S, Kahraman SA, YücetaƟ S. Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Surg. 2006;24(5):637-641.

  • Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Phys Ther. 2006;86(7):955-973.

  • Temporomandibular disorders. American Association of Oral and Maxillofacial Surgeons website. Available at: http://www.aaoms.org/images/uploads/pdfs/tmj%5Fdisorders.pdf. Published 2013. Accessed February 22, 2017.

  • Temporomandibular joint (TMJ) dysfunction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114703/Temporomandibular-joint-TMJ-dysfunction. Updated May 11, 2015. Accessed February 22, 2017.

  • TMJ. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/tmj. Updated December 2010. Accessed February 22, 2017.

  • TMJ. Mouth Healthy—American Dental Association website. Available at: http://www.mouthhealthy.org/en/az-topics/t/tmj. Accessed February 22, 2017.

  • TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: https://www.nidcr.nih.gov/oralhealth/Topics/TMJ/TMJDisorders.htm. Updated April 2015. Accessed February 22, 2017.

  • von Lindern JJ, Niederhagen B, Bergé S, Appel T. Type A botulinum toxin in the treatment of chronic facial pain associated with masticatory hyperactivity. J Oral Maxillofac Surg. 2003;61(7):774-778.