TMJ Disorders

Diagnosis

Your healthcare professional will likely discuss your symptoms and examine your jaw by:

• Listening to and feeling your jaw while you open and close your mouth
• Observing the range of motion in your jaw
• Pressing on areas around your jaw to identify points of pain or discomfort

If your healthcare professional suspects a TMJ disorder, you may need additional tests:

• Dental X-rays to evaluate your teeth and jaw
• CT scan for detailed images of the bones involved in the joint
• MRI to assess the joint’s disk and surrounding soft tissue

TMJ arthroscopy may also be used for diagnosis. In this procedure, a small thin tube called a cannula is inserted into the joint space, followed by a tiny camera (arthroscope) to visualize the area. Arthroscopy can also help with treatment by releasing scar tissue and removing inflammatory tissue to improve jaw movement and reduce pain.

Treatment

Sometimes TMJ disorder symptoms resolve without treatment. When symptoms persist, healthcare professionals often recommend a combination of approaches.

Medications
To help relieve pain and inflammation:

• Pain relievers and anti-inflammatories: Over-the-counter medications may be sufficient, or prescription-strength ibuprofen can be used for a limited time
• Tricyclic antidepressants: Low doses of drugs like nortriptyline may help reduce pain, control teeth grinding, and improve sleep
• Muscle relaxants: Short-term use can ease pain caused by muscle spasms

Therapies
Non-drug approaches include:

• Self-care: Apply heat or ice depending on symptoms, avoid teeth clenching or gum chewing, and maintain proper jaw posture
• Oral splints or mouth guards: Devices inserted over the teeth may reduce jaw pain
• Physical therapy: Exercises to stretch and strengthen jaw muscles, along with ultrasound, TENS, moist heat, and repeated stretching
• Counseling: Education on habits that worsen pain, such as teeth grinding, leaning on the chin, or nail biting

Surgical or other procedures
When conservative treatments are ineffective, your healthcare professional may suggest procedures such as:

• Arthrocentesis: Minimally invasive needle procedure to flush debris and inflammatory byproducts from the joint
• Injections: Corticosteroid injections or, in rare cases, Botox injections into jaw muscles to reduce pain
• TMJ arthroscopy: Small instruments inserted via a cannula allow minimally invasive surgery with fewer risks than open-joint surgery
• Modified condylotomy: Surgery on the mandible (without entering the joint) to ease pain and locking
• Open-joint surgery: Performed when structural issues cause persistent pain; used to repair or replace the joint and involves higher risks

If surgery or other procedures are recommended, discuss the benefits, risks, and alternatives with your healthcare professional to make an informed decision.