Many people with temporomandibular joint problems (TMJ ) recover without any treatment. TMJ disorders that may require treatment are those that include:
- arthritis
- damage to the inside of the joint
- developmental or congenital abnormalities
- injury
- muscle pain and tightness
- reduced or excessive mobility of the joint
If the TMJ disorder is caused by inflammation within the joint, physical therapy and medications such as acetylsalicylic acid* (ASA), other nonsteroidal anti-inflammatory drugs (NSAIDs), or muscle relaxants work quite well. If a person is experiencing severe pain and inflammation, the doctor or dentist may recommend that a corticosteroid or a local anesthetic medication be injected into the joint to reduce discomfort. Acupuncture, acupressure, massage, and hypnosis are other techniques used by some dentists to decrease pain and to relax muscles.
A soft diet may be recommended to reduce the strain on the TMJ caused by biting and chewing.
If you're aware that you clench or grind your teeth, you can take steps to break the habit. Splint therapy is the most popular and least invasive treatment. A thin plastic night guard is specially made to fit over either your upper or lower set of teeth and is then adjusted to provide you with an even bite. Most night guards are worn at night to reduce grinding, although they can also be used during the day. They can also prevent damage to your teeth. In addition, biofeedback or relaxation therapy, physical therapy, other behaviour modification techniques, and therapeutic jaw exercises can help.
If you have abnormalities in the alignment of your teeth that are causing TMJ problems, your dentist may correct this by balancing biting surfaces, replacing missing teeth, or replacing uneven or defective fillings or crowns.
Misalignment of the TMJ is usually treated with a plastic bite plate or splint that helps promote better alignment of your jawbones. This corrective device is also worn over your teeth and will help to re-establish proper alignment. As with the night guard used to prevent grinding, you should bring this device with you when you visit your dentist, as it may need to be adjusted occasionally.
Your dentist may also recommend changes in your chewing habits such as limiting gum chewing or avoiding firm foods such as caramels, non-tender meats, raw carrots, and celery. You may also be asked to try to limit opening your mouth wide when you yawn.
If your symptoms continue despite treatment, you may be referred to a specialist in oral and maxillofacial surgery to repair or to remove the disc that separates the adjacent bony surfaces of the TMJ or to realign the bones.
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