TMJ Treatment
Options
New York City
There
are a whole host of conservative TMJ treatment options.
The first and foremost is your self-awareness of your grinding
or clenching habit (oral stress) that can be controlled
during the daytime. Home exercises and physical therapy are an adjunct to the delivery by your dentist of a mouth guard
which will help reduce the intensity and frequency of your
oral stress and inevitably and subsequently protect your teeth
from further wear and destruction. This will restore the muscles
of your head and neck area to normal length, function, posture
and full range of motion.
Splint
|
Splint
in Mouth |
The
following treatments may be used for TMJ conditions:
Occlusal
Splint - Also called a night guard, it is designed to
protect the teeth from further wear. This also will reduce
the severity of grinding at night and allow the muscles to
rest. In more severe cases it may need to also be worn all day to allow the TMJs and muscles to rest.
Jaw Rest - You must rest your jaw for it
to heal. The occlusal splint will help somewhat but other
steps should be taken. You should not chew gum at all, bite
your nails, clench your teeth together while awake, or any
other non-functional jaw habits (pencil chewing, etc.) Your
diet should be fairly soft - you should avoid excessively chewy and crunchy foods
during treatment.
Medication - Pain medication can be prescribed.
Often, over the counter analgesics such as ibuprofen are enough.
Sometimes we will prescribe medicine similar to ibuprofen
but a bit stronger. These medications not only relieve pain
but reduce inflammation and will also aid in the healing process.
Occasionally a mild muscle relaxant may be prescribed. Narcotic
medications are not very helpful in treating TMJ and are rarely
prescribed.
The most effective drugs for TMJ management include:
1. Non-narcotic
analgesic drugs such as acetaminophen (Tylenol).
2. Non-steroidal anti-inflammatory drugs (NSAIDS) such as
aspirin, Trilisate, ibuprofen, Naproxen and prescription strength
NSAIDS.
3. Muscle relaxant drugs such as Carisoprodol (Soma) and Cyclobenzaprine
(Flexeril).
4. Tricyclic anti-depressant medications such as Amitriptyline
(Elavil), Nortriptyline (Pamelor), and Doxepin (Sinequan).
Moist Heat
- Moist heat is very helpful for the sore muscles of TMJ.
The penetrating moist heat promotes blood flow into the muscle
which aids in healing and relaxation of the muscle as well.
This increased blood flow also helps analgesic/anti-inflammatory
medications into the muscles. A wet washcloth with a hot water
bottle will do, or you can purchase moist heating pads if
you wish.
Exercises - Some simple jaw and neck exercises
may be recommended, which will help the muscles stretch. A good time to do some
of these is in the warm, moist environment of the shower or
bath, particularly in the morning and/or before bedtime.
Physical Therapy - Physical therapy can help relax
the muscles, increase joint flexibility, and the like. We
can do some simple stretching therapy in the office if needed.
If you need more involved therapy you will be referred to
a physical therapist.
Stress
Management - Emotion and stress plays an important
role in TMJ. TMJ may be a sign that you are under stress
which you are not quite aware of. Anything that helps you
relieve stress is helpful, such as reading, exercising, listening
to music, and the like. If the stress is getting to be a bit
much, counseling is often helpful in order to learn stress management.
Counseling is also recommended if you feel you need help with
any emotional problem. It is almost impossible to get relief
from TMJ if the underlying emotional issues are not addressed.
Referral - Specialists may be needed to optimally
treat your case. Opinions and/or treatment may be sought from
physicians, oral surgeons, orthodontists, psychotherapists,
physical therapists, or prosthodontists. Very severe cases
may be referred from the start to a pain center or a dentist
whose main focus is the treatment of temporomandibular disorders.
Anterior
Deprogrammer
Another method to treat TMJ symptoms is by using an anterior
deprogrammer. This device contacts the four lower incisors
when you close your mouth, and reduces resistance when the
lower jaw moves back and forth. It reduces muscle contraction
intensity and allows a musculoskeletally optimal position
for your condyle. An anterior deprogrammer is meant for short
term use and in emergency situations.
Read
more about Patient
Self Care for TMJ disorders.
|
