In USA ¼ of people show signs of e temporomandibular disorder (TMD). Most of the time the symptoms disappear on their own without the need for professional treatment, because of the great capacity of the joint to adapt in different conditions. Only 5-10 % of people with TMD symptoms need treatment.
The majority of people with TMJ disorder are woman and that is explained by the laxity of their tissues. They represent 90% of the patients who seek help. Most of the time TMD treatments are simple and can be done at home as long as you follow correctly your dentist advices. Only rarely severe cases may need invasive treatments with splints, surgery etc.
The most important measure when you are experiencing TMD symptoms is resting the jaw. Stop bad habits like keeping objects in your mouth most of the time, or even chewing gums all day. Do not stay in difficult positions when studying or sleeping, like pressing in the jaw. Use soft foods like fish, soup, well cooked vegetables etc, and avoid any hard foods for some time.
Massage your muscles as directed by your doctor might help relieving the discomfort, also some exercise might help.
Also applying heat or ice bags on the side of the jaw that you feel discomfort can help relaxing the muscles and so help you feel better.
You can take over the counter pain killers to stop the pain, but careful if the pain persist for more than 2 weeks you should talk about it with your dentist and he can choose another suitable therapy for you.
Painkillers. If the usual painkillers, over the counter medications aren’t helping you to stop the pain, your dentist may prescribe stronger painkillers.
Antianxiety medications. A low dose of tricyclic anti depressant like amitriptyline taken at bed time help stop top the pain.
Muscle relaxants. Can be use for a few days to relieve the pain of TMD. Managing stress with massages, yoga or counseling are also helpful to reduce the pain.
Corticosteroids. If you are experiencing severe pain and TMJ inflammation, these drugs can be injected directly in the joint space to stop pain.
Botulinum toxin. Injecting it ( Botox) into the jaw muscles may relieve the pain.
Bite guard or splints. Grinding and clenching your teeth can stress you muscles and a bite guard can help reduce the stress. Bite guard are designed to keep your jaw in a more relaxed position, preventing also clenching and grinding your teeth. They prevent the usury of the teeth’s occlusal surfaces that if happens will enhance your pain. There are different types of mouth guard and only your doctor can decide what is best for you. Some of them fit the upper teeth, some the lower teeth. The latest types fit only the first teeth and they function just by separating the back teeth, so the muscles used for mastication can relax.
Cognitive behavioral therapy. If you poorly manage stress or anxiety your doctor may refer you to a psychotherapist so you can change bad behaviors, manage stress and anxiety a learn relaxation technique.
Occlusal Equilibration. If your TMJ symptoms are not caused by structural disorder but from interferences on your teeth due to incongruous restorations, crowns or dental bridges, your dentist will rebuild them in the correct way. It involves reshaping of the biting surfaces and the alignment of the teeth, but if done by not experience dentist it may worsen your symptoms.
Surgical procedure. Are absolutely the last resort. They are performed under general or local anesthesia depending on the type of surgery.
1. Arthrocentesis. Is a minor surgical procedure, done by inserting a needle into the affected joint space by the ear, than sterile solutions like steroids, lubrificants or other medications are irrigated to remove debridis and inflammatory byproducts.
2. Arthroscopy. This is a more invasive procedure. The surgeon makes an incision at the temple in front of the ear to reach an endoscope into the surrounding area. It makes it possible for the surgeon to see the area and so he can remove any adhesion, reposition the disk or treat an inflammation.
3. Open-joint surgery. It is used in case of severe problems of the TMJs like tumors, chipped bones, severe scarring etc.
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