The treatment of temporomandibular joint (TMJ) disorders aims at addressing the underlying cause of the disorder. The goals of treatment are to reduce pain and other discomfort and/or to restore normal function of the lower jaw or mandible.
Non-surgical treatments are considered first and may have positive results in treating many types of TMJ disorders.1 This page discusses a few non-surgical treatments.
Following certain techniques and therapies may provide relief from TMJ disorder pain and discomfort, while also preventing exacerbation or recurrence of pain. A few self-care techniques for TMJ disorders are:
- Heat and/or ice therapy. Applying moist heat over the TMJ may help improve function and reduce pain. Ice packs help numb the pain and decrease inflammation. Ice packs may also reduce swelling by constricting small blood vessels. Ice and/or heat therapy is limited to 15 or 20 minutes at a time with at least a 2-hour break in between applications to reduce the risk for a skin injury.
- Soft diet. Eating soft or mashed foods helps avoid the need for biting and chewing, which helps reduce the load on the TMJ.
- Good jaw posture. While at rest, maintaining a correct jaw posture is essential for creating a harmony between the lips, face and jaw muscles, teeth, and tongue. This posture may be achieved by:
- Relaxing the lips and facial muscles
- Keeping the teeth apart
- Placing the tongue on the roof of the mouth behind the front teeth
Maintaining a good neck and back posture by sitting tall with shoulders back and without protruding the head forward also helps relax the jaw muscles.
- Avoid excessive mouth opening. Avoiding or minimizing activities that require the mouth to be opened wide may prevent extra stress on the TMJ and/or locking of the TMJ. Examples of such activities include biting whole fruits or corn on the cob, yelling, singing and/or yawning. Using the fist to support the chin while yawning may help prevent the jaw from locking.
- Side sleeping. Sleeping on the side with a pillow to support the neck and shoulder may help prevent stretching the jaw and neck muscles.
- Relaxation techniques. Yoga, massage, meditation, guided imagery, and/or slow and deep breathing exercises may be useful in calming TMJ disorder pain.
While following these techniques, it is also important to avoid activities or habits that may worsen TMJ disorders, such as chewing gum, clenching the jaw, and cradling the phone between the ear and the shoulder, which may irritate the muscles of the jaw and neck.
Both over-the-counter (OTC) and prescription medications may be used to relieve symptoms of TMJ disorders. Commonly used medications include:
- Non-steroidal anti-inflammatory drugs (NSAIDs), are useful in relieving mild to moderate pain in TMJ disorders associated with inflammatory processes, such as synovitis or myositis.
- Opioids may be useful in relieving moderate to severe pain and also help to control the emotional response to pain. Opioids are prescribed for short periods due to their potential for addiction and other serious side effects.
- Tranquilizers may be useful in treating high levels of emotional stress and/or chronic orofacial pain from TMJ disorders.
Other drugs for TMJ disorder pain include anxiolytics, muscle relaxants, and/or antidepressants. Due to the risk of side effects associated with medications, treatment programs may vary based on the associated benefits and risks.
Occlusal Splint Therapy
Occlusal splint therapy involves the use of a bite guard or occlusal appliance to protect the teeth and TMJ from load damage resulting as a consequence of clenching and/or grinding the teeth during sleep. The bite guard covers the surfaces of both upper and lower teeth, and do not let them come directly in contact with each other—reducing load on the teeth and TMJ. This mechanism may also prevent maximum contraction of muscles due to non-contact of teeth, in turn reducing muscle pain.
A physical therapist or other trained health professional can design a program to help treat muscle pain and locked jaw associated with TMJ disorders. Physical therapy may include jaw exercises, postural training, stretches, and manual therapy. Dry needling, transcutaneous electrical nerve stimulation (TENS) therapy, jaw exercises, pulsed ultrasound therapy, and/or other therapies may also be included in a TMJ disorder physical therapy program.
Cognitive Behavioral Therapy
Behavioral habits that sustain or exacerbate TMJ disorders may be managed by behavior modification strategies, such as lifestyle counseling, hypnosis, biofeedback, and/or relaxation therapies. These methods are usually used when simple patient awareness does not help in controlling the TMJ offending behaviors.
When the cause of TMJ disorders is from an underlying psychological or psychiatric disorder, such as anxiety or depression, psychotherapy is usually included as part of the overall treatment program.