Below, I’ve tried to take some of the mystery out of TMD treatment and simplify the myriad of options you have when dealing with this disorder. All of these should be chosen in consultation with your dentist, TMD specialist, or ENT doctor, or a combination.
I’ve listed these treatments for TMD in the order you should approach them — start at the beginning of the list and work your way down. It’s best to conservatively treat in the beginning to see if TMD symptoms go away first before getting to the more serious treatment options, like surgery.
Give Your Jaw a Break
In many milder cases, TMD symptoms will go away just by letting the overworked jaw muscles rest.
If you’re getting clicking or popping when you yawn or open your mouth wide, try not to open wide for the next several days.
Cut smaller pieces of food so that you don’t have to open as wide to take a bite or chew as hard. Limit the amount of tough chewing with a softer diet.
Cut out chewing gum.
Treat It Like a Muscle Injury
Try treating your jaw the same way you would a pulled muscle. Massage the jaw muscle, put a hot washcloth on it, take an anti-inflammatory like ibuprofen, and let it rest.
Try Muscle Relaxation Exercises
Just like a muscle that cramps from overuse, the jaw can cramp from too much use. Simple exercises can help you learn how to correct abnormal jaw positioning and relax tense jaw muscles that can contribute to TMD pain. All exercises should be done during times when you do not have any pain.
If your jaw starts to hurt while you are performing the exercises, stop and rest. Jaw positioning exercises should be done in front a mirror so you can watch your progress.
Many people who have TMD have a deviation in the way the joint moves, but are capable of learning a new, more correct position. Put a small sticker on the middle of your chin and open your mouth. If your jaw shifts to the side when you open your mouth, the sticker will shift also. When you see this happening, make a conscious effort to keep your jaw perfectly aligned when you open your mouth.
It may feel unnatural at first but over time it will feel more normal and you may notice a reduction in your joint pain.
Muscle relaxation and stretching exercises can be done anywhere, at home, in the car or while you read a book. Gently open your mouth as wide as you can without discomfort. Close your mouth slowly. Once your muscles have loosened up, you can use your hand very carefully to open your mouth a little bit wider.
This type of stretching can prevent your jaw from becoming locked or unable to open and close smoothly.
Check Your Posture
Poor posture places the spine in a position that causes stress to the jaw joint. When people slouch or hunch over, the lower jaw shifts forward, causing the upper and lower teeth to not fit together properly, and the skull moves back on the spinal column.
This movement puts stress on muscles, joints and bones and, if left untreated, can create pain and inflammation in muscles and joints when the mouth opens and closes.
Find Out If You Have Sleep Apnea
TMD is often caused by grinding the teeth at night, which is a sign that you’re struggling to keep your airway open while you sleep. Recent studies are showing that TMD symptoms are often indicators of a larger disorder – and that includes sleep apnea.
A mandibular advancement device, which is made by your dentist and used to treat sleep apnea, often cures TMD because it positions the jaw in a such a way that forces it to relax completely.
Assuming the device is worn at night, eight hours of forced relaxation every day can be very effective in reversing TMD symptoms.
Check Your Stress Levels
We often clench without realizing it – and TMD can often be resolved by treating a root cause of major stress, unhappiness in work or at home, etc.
Try Medicinal Marijuana
This can work well for people who have tried other methods of controlling their stress levels, but still have jaw pain.
If there is no pathology in the joint, meaning there is nothing actually wrong with the jaw that is causing the pain, medicinal marijuana can work to help relax the joint and curb grinding, which aggravates TMD symptoms and can be brought on by stress.
Join a Support Group
The TMJ Association is a non-profit organization that focuses on patient advocacy.
Especially for severe sufferers of TMD, this is important because you don’t want doctors and dentists pressuring you into treatment you don’t need.
Taking ibuprofen, or another anti-inflammatory, can give you immediate relief by reducing swelling or tenderness in the jaw, face, head, or neck. This kind of treatment, however, won’t work in the long term. Being dependent on painkillers is no way to live your life.
Pain is also the body’s way of telling you to stop hurting yourself — and taking this away can cause you to further damage your body. Painkillers are great for immediate relief, but be sure you are searching for and treating the root cause. Be wary of any TMD specialist, dentist, doctor or medical professional that advises you to treat your TMD with painkillers alone.
Try Occlusional Equilibration
This method can take several visits that are weeks apart until the muscles adjust and find a new position. What your dentist will try to do here is aim to equilibrate your bite in a way that gets rid of your jaw pain or other TMD symptoms.
Many people have an “actual” bite that differs from their “ideal” bite. Bringing the two positions into harmony is key in treating TMD.
This requires strong 3D thinking and premodeling on a model by your dentist in order to treat your TMD and make the teeth less of a trigger point for grinding. A stable well balanced bite puts less stress on the jaw joint.
You may need work done to reshape your teeth or jaw through braces or other appliances. A dentist can also fit you with a mouth guard that will help you stop clenching your jaw and grinding your teeth at night.
Think of this like an orthotic shoe insole for the mouth. It works to attain that balance and comfort, at least while you’re wearing it.
This should only be as a last resort after going through all of the treatment options above, experimenting with different combinations of treatments, working closely with your dentist, and getting a second (or even a third) opinion. Surgery on the actual joint has fallen out of favor. Orthognathic surgery, while an extreme option, may be necessary.
As with everything, research your options and understand what TMD is and what causes it before committing to any heavy duty treatment.
Depending on the severity of your TMD, you might need to go through some trial and error to figure out which treatment or combination of treatments works for you, but that’s where a good dentist, TMD specialist, or ENT doctor should take care of you and be your advocate throughout the process. Of course, I’m here to help as well – shoot me an email and I’ll do what I can to advise you.
Dr. Mark Burhenne DDS
As always, I want to hear from you. What is your experience with treating your TMD? What are your questions about TMD treatment? Let me know in the comments.