TMJ treatment

What it is

Problems with the jaw joints and chewing muscles are called temporomandibular disorders, or TMD. Many people simply call them TMJ.

Things that can play a part include a jaw injury, arthritis in the joint, and clenching or grinding your teeth, often at night or under stress. Often there’s no single clear cause.

Treatment usually starts with conservative care: simple steps that don’t change your teeth or jaw for good. Many jaw problems ease on their own or with simple care, and research supports starting this way.

Who it helps

An exam may help if you have:

• Pain in your jaw, face, or around your ear, especially when you chew
• A jaw that feels tight, tired, or stiff, often in the morning
• Clicking or popping that hurts, or a jaw that gets stuck open or closed
• Headaches near your temples
• Teeth that are worn, chipped, or sore from grinding

Clicking without pain is common and usually needs no treatment. Jaw pain can also come from a tooth, your sinuses, or, rarely, your heart. If jaw pain comes with chest pain, shortness of breath, or sweating, call 911.

What happens

1. Talking it through. Dr. Minici asks when the pain started, what makes it better or worse, and about habits like clenching, gum chewing, or nail biting.
2. An exam. He feels the jaw muscles and joints, watches how your jaw opens and closes, and checks your teeth for signs of grinding. Sore muscles may feel tender when pressed. X-rays may be taken.
3. Simple first steps. Care usually starts with self-care: softer foods, smaller bites, no gum, and warm or cool packs along with gentle jaw stretches. A pain reliever you can safely take may help for a short time.
4. A night guard, if it fits your case. A custom night guard is a thin, fitted plastic cover worn over your teeth at night. It’s made from impressions (molds) of your teeth. Studies are mixed on how much guards ease jaw pain, but they do protect teeth from the wear of grinding.
5. Follow-up. After a few weeks, we check how you’re doing and adjust the plan. If pain continues or the joint itself seems damaged, Dr. Minici may refer you to a physician, a physical therapist, or an oral surgeon.

Recovery and aftercare

There’s no downtime with conservative care. Any improvement is usually gradual, over weeks rather than days.

A night guard can take a few nights to get used to. At first, you may notice extra saliva, or your bite may feel a little different in the morning. Stop wearing it and call the office if it causes pain or seems to change how your teeth fit together. Clean it each morning and keep it in its case.

During the day, try to keep your lips together, your teeth apart, and your jaw relaxed. Notice when you clench, especially when you’re busy or stressed.

Cost and insurance

The cost depends on what your care includes, such as X-rays, a custom night guard, and follow-up visits. Dental plans vary on night guards: some cover them for grinding, and some don’t. Some TMJ care is covered by medical insurance instead, especially when a physician is involved, so ask both plans. To learn about payment options, see insurance and financing.

Alternatives

• Physical therapy can help with jaw movement and muscle pain.
• Short-term medicines from your physician, such as muscle relaxers, help some people.
• Stress management, such as relaxation exercises or counseling, can reduce clenching.
• Injections or surgery may help with a few specific joint problems.

Be cautious about treatments that change your bite for good as a first step, such as grinding down teeth or braces. Research doesn’t show that they help jaw pain.