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For Managing Pain and Inflammation
Application of Heat and Cold

Heat improves blood circulation to the treated area. Applying heat via warm soaks or heating pads can be very soothing. Most doctors recommend that you apply the heat for about 10 minutes at a time, 3-4 times a day.

Cold can help decrease inflammation in an affected joint, relieve pain, and improve stiffness and movement. Apply an ice pack for 20-30 minutes at a time, several times each day.

Intra-articular Corticosteroid Injections

Corticosteroid injections are rarely used for TMD, although they may be recommended for more severe cases, predominantly when the disorder is caused by inflammatory conditions such as rheumatoid arthritis . The corticosteroid medicine can help decrease inflammation and pain in the joint.

In this therapy, the affected joint is injected with a solution containing a corticosteroid medication such as:

  • Methylprednisolone
  • Triamcinolone

In the more common situation in which pain is due to muscle tension rather than TMD arthritis, injection of Botox into facial muscles can give relief of pain when other treatments have failed. Treatments may need to be repeated. The safety and efficacy of such repeated treatments have not yet been established.

Laser Therapy

There is some limited evidence that low-level laser therapy can improve symptoms, though few scientific studies provide strong guidance for choosing treatments.

For Managing Tooth Grinding and Jaw Clenching
Splint, Bite Plate, Nightguard

You doctor may order you a splint or bite plate that interferes with jaw clenching and teeth grinding. You might be advised to wear it only at night, or you might wear it at times during the day when you are more likely to grind your teeth or clench your jaw. These appliances shouldn’t alter your natural bite.

Botox

You doctor may inject Botox to weaken the muscles that cause jaw clenching.

When to Contact Your Doctor

Contact your doctor if:

  • The device or treatment seems to be increasing your pain.
  • You notice any new symptoms after you begin using the appliance or treatment.

References:

Cetiner S, Kahraman SA, et al. Evaluation of low-level laser therapy in the treatment of temporomandibular disorders. Photomed Laser Surg . 2006;24(5):637-641.

Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Phys Ther . 2006;86(7):955-973.

Siccoli MM. Facial pain: a clinical differential diagnosis. Lancet Neurology . 2006;5:257-267.

TMJ. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/tmj.cfm . Updated December 2010. Accessed April 5, 2013.

TMJ. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/tmj.aspx . Accessed April 5, 2013.

TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/TMJ . Updated March 21, 2013. Accessed April 5, 2013.

Temporomandibular joint (TMJ) dysfunction. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated November 27, 2012. Accessed April 5, 2013.

von Lindern JJ, Niederhagen B, et al. Type A botulinum toxin in the treatment of chronic facial pain associated with masticatory hyperactivity. J Oral Maxillofac Surg . 2003;61(7):774-778.



Last reviewed February 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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