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Patient Bone-Related Safety of Botox® for Treatment of TMD

Karen Raphael, PhD, a long-time TMD researcher now at the New York University College of Dentistry, has provided the following commentary on the Susan Herring Botox® article, along with information on her plans for clinical studies of TMD patients who have been treated with Botulinum Toxin for TMD Pain.

Further Evidence that Botox® Injections Cause Bone Loss in the Jaw

An article published online in the journal Bone* by a team of French investigators confirms that injecting Botox® into jaw muscles leads to significant bone loss in adult rats.

MAPP Network Basic/Translational Science

The OPPERA study has demonstrated that pelvic pain is moderately associated with Temporomandibualr Disorders. Given this relationship we are publicizing this new NIH research opportunity.   The Multidisciplinary Approach to the Study of Chronic P

Immune System Plasticity in the Pathogenesis and Treatment of Complex Dental, Oral, and Craniofacial Diseases

Its purpose is to expand contemporary, systematic research approaches to elucidate the role of immune system plasticity in health and in the pathogenesis of dental, oral, and craniofacial (DOC) diseases. The goal is to advance knowledge of the immunologi

Ethics of TMD Treatments

When we read an article by Drs. Kevin Reid and Charles Greene on the ethics of TMD treatment in the Journal of Oral Rehabilitation, we thought the message was so important that we asked them to write on this topic for our readers.

HELP YOURSELF FIRST - REMEMBER LESS IS BEST!

  • Jun 22, 2014

Often jaw problems resolve on their own in several weeks to months. If you have recently experienced TMJ pain and/or dysfunction, you may find relief with some or all of the following therapies.

  • Moist Heat. Moist heat from a heat pack or a hot water bottle wrapped in a warm, moist towel can improve function and reduce pain. Be careful to avoid burning yourself when using heat.
  • Ice. Ice packs can decrease inflammation and also numb pain and promote healing. Do not place an ice pack directly on your skin. Keep the pack wrapped in a clean cloth while you are using it. Do not use an ice pack for more than 10 - 15 minutes.
  • Soft Diet. Soft or blended foods allow the jaw to rest temporarily. Remember to avoid hard, crunchy, and chewy foods. Do not stretch your mouth to accommodate such foods as corn on the cob, apples, or whole fruits.
  • Over the-Counter Analgesics. For many people with TMJ Disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, your dentist or doctor can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or antidepressants to help ease symptoms.
  • Jaw Exercises. Slow, gentle jaw exercises may help increase jaw mobility and healing. Your health care provider or a physical therapist can evaluate your condition and suggest appropriate exercises based on your individual needs.  A recent study found therapeutic jaw exercises bring earlier recovery of jaw function compared to splints! Click here to read the specific jaw exercises used in this study.
  • Relaxation Techniques. Relaxation and guided imagery can be helpful in dealing with the pain that accompanies TMJ dysfunction. Deep, slow breathing enhances relaxation and modulates pain sensations. Some have found yoga, massage, and meditation helpful in reducing stress and aiding relaxation.
  • Side Sleeping. Sleep on your side using pillow support between shoulder and neck.
  • Relax Facial Muscles. Make a concerted effort to relax your lips, and keep teeth apart.
  • Yawning. Use your fist to support your chin as you yawn to prevent damage to the joint and prevent your jaw from locking open.

In addition, avoid:

  • Jaw clenching.
  • Gum chewing.
  • Cradling the telephone, which may irritate jaw and neck muscles.

Be sure to discuss your jaw limitations with your doctor prior to surgery or a long dental appointment so he/she uses extreme caution. Anesthesia, often used during dental procedures, can affect mouth opening and damage the joint. If possible, avoid long dental appointments requiring an open mouth for more than 30 minutes. For more information about this topic, please review our Dental Hygiene Brochure (.pdf).

Remember, if your TMJ problems get worse with time, you should seek professional advice. However, first and foremost, educate yourself. Informed patients are better able to talk with health care providers, ask questions, and make knowledgeable decisions. By seeking out the information on this website, you are on the road to being an informed patient and better able to help yourself.

We suggest you read through and print out our list of questions (.pdf) to ask your doctor prior to consenting to any treatment.


In Treating TMJ

To view or order a free booklet about TMJ Disorders, visit the National Institutes of Health website.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
National Institutes of Health
National Institute of Dental and Craniofacial Research
Office of Research on Women's Health