Temporomandibular Joint (TMJ) Disorders

Your doctor will educate you about lifestyle habits you can adapt and self-care measures you can practice at home if they believe these efforts can be effective in reducing your pain.

In some cases, over-the-counter pain relievers may be recommended to relieve TMJ pain. If your doctor doesn’t think they will be effective for your condition, they may prescribe prescription-strength pain relievers, such as ibuprofen or other medications like muscle relaxants, antidepressants, or antiepileptic medications to manage your pain.

Hard, acrylic mouth guards, also called “splints” can serve two purposes. They may help stabilize your jaw in a comfortable position. They may also protect your teeth from nighttime clenching and grinding. Usually, they are most effective when your dentist creates a custom oral appliance for you.

• Trigger Point Injections. Trigger points are sensitive taut muscle bands in your muscles that can cause referred pain. A trigger point injection with local anesthesia can help break down these taut bands, relax the muscles, and alleviate pain.
• Steroid Injections. A steroid in the TMJ may help alleviate pain.
• Botulinum Toxin A (Botox) Injections. Botox may be injected to relieve and relax the muscle.

Your doctor may recommend physical therapy, which incorporates exercises that strengthen and stretch your jaw muscles. They may also perform dry needling, a procedure in which fine needles are inserted in the area to help relieve pain and reduce inflammation.

Our psychologists offer techniques to reduce distress, tension, and negative thoughts that exacerbate TMJ symptoms. We also help you learn to cope with pain to lessen its impact on your life.

Our licensed massage therapist uses medical massage on the muscles, tissues, and structures surrounding the jaw to relieve pain and TMJ symptoms.

In some cases, you may be referred for a series of acupuncture treatments to relieve pain. Sterile acupuncture needles inserted at various points in the body are thought to stimulate the body’s natural, pain-relieving abilities.

This minimally invasive procedure may be performed to alleviate joint stiffness that results from fluid buildup. After administering a local anesthetic, your surgeon will inject a sterile fluid to rinse away excessive fluids that may cause inflammation. During the procedure, your surgeon may also manipulate the jaw to break up scar tissue and move the jaw into correct alignment. Pain-relieving or anti-inflammatory medications may be injected into the jaw at the same time. This procedure is performed at an ambulatory surgery center, meaning you will go home the same day. You may experience some bruising and swelling at the site, which should go away in several days.

During this procedure, your surgeon will insert a small camera, called a scope, through a small cut in your skin to view the inside of your jaw joint. This allows the surgeon to see whether the joint is damaged or loose, if disc problems are present, or if there is a cartilage concern. The surgeon can correct many problems during the procedure as well. TMJ arthroscopy is usually performed in an ambulatory surgery center, meaning you will go home the same day. Swelling may last up to seven days. It is normal to experience a change in your bite and to hear some clicking noises in your jaw following surgery.

A total joint replacement may be performed if you are diagnosed with end-stage joint disease. The procedure replaces the jaw joint with a prosthetic device made from a combination of artificial materials. Duke surgeons only use custom-made prosthetics when performing these procedures. This means every person’s artificial jaw joint is unique to their facial structure. This procedure is performed in the hospital. Recovery can take six to 12 weeks.