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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Goals of the presented modalities are to:

  • 1) increase mandibular range of motion,
  • 2) decrease joint and masticatory muscle pain and inflammation, and
  • 3) prevent further degenerative change in articulating tissues, including direct or indirect joint damage

  • generally, the signs and symptoms of TMJ disorders improve over time with or without treatment (1)
  • about 50 % improve in one year and 85 % improve completely in three years (1)

  • conservative treatments (2)
    • self-care practices
      • these steps may be helpful in easing symptoms, such as:
        • eating soft foods
        • warm compress over the region of pain (5)
        • avoiding extreme jaw movements
        • stress-relieving relaxation techniques for relaxing and reducing stress (3)
        • practicing gentle jaw stretching and relaxing exercises

    • medications
      • nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort.
      • muscle relaxants
      • anti-depressants
        • tricyclic antidepressants can be used to treat pain (including pain from nighttime bruxism) (1)
        • antidepressants that are used in chronic pain syndromes may also be helpful
        • care should be taken when prescribing selective serotonin reuptake inhibitors
          • these may rarely cause bruxism (1)

    • stabilization splints
      • non-invasive, occlusal splints and occlusal adjustments work to establish balance in the occlusion and TMJs (4)
        • the occlusion, or bite position, is a third and important element in the joint system and is the element often addressed by general dentists
          • ultimate goal of splints and adjustments is to minimize pain in the joint and masticatory muscles by establishing stability
          • splints may be used to control bruxism, which has been associated with tooth attrition, malocclusion, myofacial pain, and masticatory muscle strain, fatigue, and fibrosis
          • long-term effectiveness of this therapy remains controversial

  • irreversible treatments (2)
    • surgery
    • implants

For NICE guidance regarding management of chronic pain (pain that lasts for more than 3 months) then see linked item.

Reference:


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