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Dr. Martin R. Aidelbaum Inc. |
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Treatment Options For TMJ Disorders In the treatment of TMJ disorders you will be working in partnership with your surgeon and in some cases your orthodontist and restorative dentist. It is important to know that most types of TMJ disorders can be treated, in whole or at least in part, by "self-care" and specific changes in lifestyle on your part. Other problems, in addition to self-care techniques, require more extensive therapy, sometimes including surgery. The following are treatment options that will be reviewed by you and your surgeon to determine the specific treatment needed in your case: |
Self-Care
In almost all cases it is important to rest the jaw by keeping the teeth apart for periods of time and to practice good posture. It may be necessary to avoid hard foods that strain the jaw when chewing. Just as resting the jaw can be beneficial, proper exercise of the jaw may also be helpful at appropriate times. Flexing exercises can help restore normal range of jaw motion in cases where jaw movement is restricted by a TMJ disorder. These exercises should consist of gentle opening/closing movements to avoid stressing the joint. Moist heat can be used to help relax muscles, and in cases of joint injury ice packs applied soon after the injury can help reduce swelling. Counseling on relaxation techniques may also be part of your self-care program, and your surgeon may prescribe medications such as muscle relaxants and/or anti-inflammatory drugs that can help relieve discomfort and reduce inflammation.
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Moist heat applied to the face in the join area can help to relax muscles. |
Physical Therapy
There are a variety of physical therapy techniques that can be used to treat certain types of TMJ disorders, and these may require referral to the appropriate specialist. These techniques include jaw exercises, posture training, electrical stimulation, ultrasound, biofeedback, and others.
Dental Treatment/Splint Therapy
Your surgeon may recommend the construction of a nightguard device, or occlusal splint to be worn for varying amounts of time, depending on the nature of your TMJ problem. There are many types of splints to help reposition the jaw, prevent clenching and grinding of the teeth, rest the jaws, and help relax jaw muscles. Orthodontic treatment or dental treatment such as restorations to correct a defective bite may be necessary and potentially therapeutic as they restore proper harmony between the teeth, muscles and joint. If the position of the jaws is incorrect, corrective jaw surgery to reposition the upper and/or lower jaw may be indicated to restore balance and be potentially helpful in resolving the disorder.
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Bite plates can help prevent clenching and grinding or reposition the jaw to relax the joint area. |
TMJ Surgical Options
It is important to understand that even if non-invasive procedures are ineffective in certain cases, surgery may not be the next step if the diagnosis indicates that surgical procedures will not help; for example, if your problem is muscular in origin rather than originating from within the joint itself. However, in cases where the diagnosis indicates a specific problem within the TMJ, joint surgery may be an appropriate treatment. Following are surgical options you and your doctor may consider:
Arthroscopy - An arthroscope is a miniature telescopic instrument, like that used for many years with knee joints, through which the contents of the jaw joint can be viewed. Using a special arthroscope small enough to enter the TMJ, the surgeon can visualize the joint and can perform minor surgical procedures such as treating cartilage damage. Arthroscopic surgery is performed in a hospital or ambulatory surgical center under general anesthesia, using the same sterile and surgical conditions as for other types of joint surgery. With the patient asleep, the TMJ is injected with a local anesthetic and sterile solutions to flush out the joint. The TMJ is then carefully entered with the arthroscope. After the arthroscope has been placed, a small camera is connected to the instrument at one end and to VCR equipment at the other end. The surgeon views the magnified anatomy of the joint on a television screen while the surgical field is under irrigation with sterile solutions. The surgeon can then perform needed treatment, such as removing scar tissue that is interfering with joint function.
Arthroplasty - In some cases arthroscopic surgery may be incapable of correcting a TMJ problem and other surgical procedures may be considered. For example, if a disc is displaced and can not be moved back into proper position, then "open" surgery may be needed to expose the joint and allow more complex treatment procedures to be performed. Arthroplasty involves making an incision in front of the ear to expose the joint so the surgeon can repair a disc or ligament.
More complex TMJ surgery - In the event of severe joint deterioration, such as may occur in certain cases of arthritis affecting the TMJ, more extensive surgical procedures are available to treat the problem. As with arthroplasty, an external excision is made to expose the joint, and then procedures such as recontouring the bone of the joint, replacement of a disc, or rarely, artificial replacement of the entire joint, can be performed.