There are many types of treatment available for TMD and facial pain, falling into two broad categories.
1. CONSERVATIVE TREATMENT- these are reversible forms of treatment such as exercise, medications, physical therapy, and bite appliances.
2. NON-REVERSIBLE TREATMENT - These treatments are invasive and can not be reversed such as grinding teeth down, capping teeth, and open joint surgery.
The good news is that most TMD problems respond well to conservative, reversible treatment. Simple home care consisting of massage and jaw stretching exercises, adhering to a soft food diet, and avoiding damaging habits such as tooth clenching bring relief to many people. The use of medications and oral appliances are also helpful in alleviating TMD symptoms. It is almost always recommended that patients start with conservative care and if that is not sufficient then consider more invasive treatments.
Since oral appliances are commonly prescribed, additional information is warranted. Oral appliances have various names: bite plates, night guards, splints, and orthotics , to name a few. They all refer to the same thing. A bite plate is a piece of plastic which covers either the upper or lower teeth. It snaps over the teeth and is easily removed for cleaning. It helps to relax the jaw muscles, it reduces pressure on the jaw joint, and protects the natural teeth from being worn down. Not all bite plates are designed the same way. If used improperly a bite plate can alter the bite unintentionally. If designed correctly and not worn 24 hours a day it should not alter the bite.
SURGERY - If conservative treatments are not effective and there is something in the TM joint to fix then surgery may be appropriate. The benefits and risks of surgery must be fully discussed with the surgeon prior to any decision. Surgery when appropriately indicated has benefited many patients. There are two types of surgery available:
Arthroscopic Surgery - A fiber optic needle is inserted into the joint, the damage can be visualized and through a second needle very small instruments are utilized to make surgical repairs, deposit medications very accurately, and flush out and clean the joint. The risk level of this procedure is low and the recuperations time is fast.
Open Joint Surgery - There are certain times when it is necessary to open the joint surgically to repair the damage. Although more invasive than arthroscopy, more definitive repair is possible with open joint surgery however, the healing time is longer.
