Understanding temporomandibular disorders: causes and treatments - Spire Healthcare

Treatment options for TMDs

Only about 10% of people with a TMD need treatment. In most cases when stress is the cause of the TMD, once the stressful situation has passed and the muscles relax, the TMD goes away on its own. 

In those cases where treatment is needed, especially if you have frequent muscle spasms, your maxillofacial surgeon may recommend you see a physiotherapist who specialises in treating the jaw joint.

Your surgeon may also recommend injection of botulinum toxin to ease muscle spasms. This shouldn't be administered by a general dentist or someone who performs cosmetic botulinum toxin injections but by a doctor trained in using botulinum toxin for the treatment of TMDs. Botulinum toxin needs to be injected into precise locations and if injected into the wrong place can cause weakness in the movement of the corner of your mouth. 

Surgery

If other conservative treatments have not been successful in treating your TMD ie rest, muscle massage, taking anti-inflammatory medication and wearing a bite splint, and you have persistent joint pain, surgery may be appropriate. Persistent joint pain refers to joint pain that is temporarily relieved by having an injection.

In most cases, the initial surgery recommended is an arthroscopy or arthrocentesis.

An arthroscopy is where a thin, telescope-like tube with a light and camera on the end (an arthroscope) is inserted into your jaw via a small cut to see what is going on inside it. This is a more accurate means of diagnosis than an MRI scan. An MRI scan will not provide the information needed to determine if surgery will be effective and should therefore only be used to support a diagnosis.

During an arthroscopy, depending on what your surgeon finds, they may be able to treat your condition by removing inflamed tissue, repositioning a slipped cartilage disc and rinsing out the joint.

An arthrocentesis is a wash out of your TMJ under pressure and can give significant relief of symptoms.