TMJ

Signs and symptoms of TMJ disorders may include:

– Pain or tenderness of your jaw
– Aching pain in and around your ear
– Difficulty chewing or discomfort while chewing
– Aching facial pain
– Locking of the joint, making it difficult to open or close your mouth

TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. But if there’s no pain or limitation of movement associated with your jaw clicking, you probably don’t need treatment for a TMJ disorder.

The temporomandibular joint (TMJ) combines a hinge action with sliding motions. The parts of the bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disk, which normally keeps the movement smooth.

Painful TMJ disorders can occur if:

– The disk erodes or moves out of its proper alignment
– The joint’s cartilage is damaged by arthritis
– The joint is damaged by a blow or other impact

​In many cases, however, the cause of TMJ disorders isn’t clear.

During the physical exam, Dr McHugh will likely:

– Listen to and feel your jaw when you open and close your mouth
– Observe the range of motion in your jaw
– Press on areas around your jaw to identify sites of pain or discomfort

If Dr McHugh suspects a problem with your teeth, you may need X-rays. A CT scan can provide detailed images of the bones involved in the joint, and MRIs can reveal problems with the joint’s disk.

In some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend a variety of treatment options.

​MEDICATIONS

In conjunction with other nonsurgical treatments, medications that may help relieve the pain associated with TMJ disorders may include:

– Pain relievers. If over-the-counter pain medications aren’t enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers.
– Tricyclic antidepressants. These medications, such as amitriptyline, used to be used mostly for depression, but now are also used for pain relief.
– Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.
– Sedatives. If nighttime teeth clenching is aggravating your pain, your doctor might prescribe a sedative such as clonazepam (Klonopin).

​THERAPIES

Nonpharmaceutical treatments for TMJ disorder include:

– Bite guards (oral splints). Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these    devices are beneficial are not well understood.

– Physical therapy. Treatments might include ultrasound, moist heat and ice — along with exercises to stretch and strengthen jaw muscles.
– Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails.

​SURGICAL & OTHER PROCEDURES

When other methods don’t help, your doctor might suggest procedures such as:

Arthrocentesis

This procedure involves the insertion of needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.

Injections

In some people, corticosteroid injections into the joint may be helpful. Infrequently, injecting botulinum toxin (Botox and others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.

Surgery

If your jaw pain does not resolve with more conservative treatments and if it appears to be caused by a structural problem within the joint, surgery make be necessary to repair or replace the joint.