The following are common TMJ treatments often recommended to patients.  Please note there currently is no treatment that has been proven to work as a preventative measure for TMJ disorders.

•  Self Help Tips
•  Acupuncture
• Injections
• Splints
• Occlusal Adjustments
• Surgical Procedures (Pending)
• Implants (Pending)

American Association for Dental Research

The American Association for Dental Research (AADR) revised their policy statement on TMJ disorders in 2010. This policy statement reflects the position of the National Institutes of Health (NIH) "Less is Best" campaign as well as what we've been saying for the past 20 years.

AADR POLICY STATEMENT ON TEMPOROMANDIBULAR DISORDERS
The AADR recognizes that temporomandibular disorders (TMDs) encompass a group of musculoskeletal and neuromuscular conditions that involve the temporomandibular joints (TMJs), the masticatory muscles, and all associated tissues. The signs and symptoms associated with these disorders are diverse, and may include difficulties with chewing, speaking, and other orofacial functions. They also are frequently associated with acute or persistent pain, and the patients often suffer from other painful disorders (comorbidities). The chronic forms of TMD pain may lead to absence from or impairment of work or social interactions, resulting in an overall reduction in the quality of life.

1. It is recommended that the differential diagnosis of TMDs or related orofacial pain conditions should be based primarily on information obtained from the patient's history, clinical examination, and when indicated TMJ radiology or other imaging procedures. The choice of adjunctive diagnostic procedures should be based upon published, peer-reviewed data showing diagnostic efficacy and safety. However, the consensus of recent scientific literature about currently available technological diagnostic devices for TMDs is that except for various imaging modalities, none of them shows the sensitivity and specificity required to separate normal subjects from TMD patients or to distinguish among TMD subgroups. Currently, standard medical diagnostic or laboratory tests that are used for evaluating similar orthopedic, rheumatological and neurological disorders may also be utilized when indicated with TMD patients. In addition, various standardized and validated psychometric tests may be used to assess the psychosocial dimensions of each patient’s TMD problem.
2.  It is strongly recommended that, unless there are specific and justifiable indications to the contrary, treatment of TMD patients initially should be based on the use of conservative, reversible and evidence-based therapeutic modalities. Studies of the natural history of many TMDs suggest that they tend to improve or resolve over time. While no specific therapies have been proven to be uniformly effective, many of the conservative modalities have proven to be at least as effective in providing symptomatic relief as most forms of invasive treatment. Because those modalities do not produce irreversible changes, they present much less risk of producing harm. Professional treatment should be augmented with a home care program, in which patients are taught about their disorder and how to manage their symptoms.

National Institutes of Health - Less is Often Best in Treating TMJ Disorders

Temporomandibular disorders, commonly called “TMJ,” are a group of painful conditions that affect the jaw joint and the muscles that control jaw movements. Injury plays a role in some TMJ problems, but for many people, symptoms seem to start without obvious reason. The good news is that for most people, pain in this area is not a signal of a serious problem.

Generally, discomfort is occasional and temporary and will go away with little or no treatment. Even if symptoms persist, most patients do not need aggressive types of treatment.

Scientists sponsored by the National Institute of Health (NIH) are looking for answers to what causes these disorders and how best to treat them. Currently, there is little scientific evidence to show which treatments work and which don’t. Until there is science based evidence to help health care providers make sound treatment decisions, the NIH suggests the following:

• Try simple self-care practices such as eating soft foods, using ice packs and avoiding extreme jaw movements, like wide yawning and gum chewing. Short-term use of over-the-counter or prescription pain medicines may also provide relief.
• Avoid treatments that cause permanent changes in the bite or jaw. Such treatments include crown and bridge work to balance the bite, orthodontics to change the bite, grinding down teeth to bring the bite into balance (occlusal adjustment), and repositioning splints, which permanently change the bite.
• Avoid, where possible, surgical treatment for TMJ. There have been no long-term studies to test the safety and effectiveness of these procedures. Before considering any surgery on the jaw joint, it’s important to get opinions from other doctors and to fully understand the risks.
• Replacement of the jaw joint(s) or disc(s) with TMJ implants should be considered only as a treatment of last resort. TMJ implants are intended to improve jaw function. Pain alone is not a reason to undergo a TMJ replacement procedure; often, after surgery, the pain level stays the same or even increases. TMJ implants may also cause permanent damage. Some of these devices may fail to function properly or may break.

Read the history of TMJ implant devices, and review a list of those devices and the manufacturers who made them at http://www.tmj.org/implants.asp.

Finding the Right Care

Because there is no certified specialty for TMJ disorders in either dentistry or medicine, finding the right care can be difficult. Look for a health care provider who understands musculoskeletal disorders (affecting muscle, bone and joints) and who is trained in treating pain conditions. Pain clinics in hospitals and universities are often a good source of advice.

NIH Publication on TMJ (.pdf) The NIH brochure on TMJ Disorders describes the causes, signs and symptoms, diagnosis and treatment of temporomandibular joint and muscle disorders. Also highlights research under way on these disorders.

Educate Yourself - Be Your Own Advocate!

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 healthcare providers, ask questions, and make knowledgeable decisions.

1. Proceed cautiously and get several independent opinions before beginning any suggested irreversible treatment.
2. When going to the doctor, it is in every patient’s best interest to always be accompanied by a person whom you trust and who will act as your advocate.
3. We recommend taking notes during your appointments.
4. You should ask a doctor these questions before consenting to any treatment:
   • What is the purpose of the proposed treatment and why is it necessary in my case?
   • Is the treatment reversible or irreversible?
   • Will this treatment reduce my pain?
   • What side effects or complications may I experience and what should be done about them?
   • Are there other treatments available?
   • What are the advantages of the proposed treatments over other forms of therapy with respect to benefits and risks?
   • How many follow-up treatments will be necessary?
   • How much will the proposed treatment cost?
   • Will insurance cover the treatment costs?
   • Is there a payment contract I must sign? (If so, ask to take the form home to review.)
   • Is there a consent form I must sign for treatment? (If so, ask to take the form home to review.)
   • Has the proposed treatment been studied in clinical trials* for safety and effectiveness?
   • Is this treatment part of a clinical trial* and if so, what are my obligations and the conditions involved in participating in this trial?

* Clinical trials involve some risk on the part of the patient. Some treatments may have unforeseen side effects. By law, researchers are required to make sure volunteers understand what will happen during and after the trial, as well as the risks and benefits. The following are questions you should ask before agreeing to participate in a clinical trial:

• What makes me a candidate for the study?
• What are the risks?
• What is involved? What will I have to do?
• What checks and balances are in place to protect my safety?
• Will I be charged anything or be compensated for my participation?
• Who is paying for the study?
• How can I end my participation if I change my mind and will you continue to treat me?
• What will happen when the study is over? Will I be told the results?
• Whom do I contact to express concerns or obtain information?
• What do the researchers hope to learn?
• Who will have access to my medical information
• Resource: Agency for Healthcare Research and Quality Informed Consent and Authorization Toolkit for Minimal Risk Research

Your healthcare provider should answer these questions in words you can understand. If you don’t understand any part of the discussion with your healthcare professional, it is important to ask that it be explained again. If your provider will not or cannot answer these questions, find one who will. You must be your own healthcare advocate.

Who Treats TMJ Disorders?

The field of temporomandibular disorders suffers from a lack of basic and clinical science. Therefore, neither the American Dental Association (ADA) nor the American Medical Association (AMA) recognizes the treatment of TMJ Disorders as a specialty. As a result, there are no established standards for dental/medical school education. Although a variety of healthcare providers advertise themselves as TMJ specialists, the more than 50 different treatments available today are based largely on beliefs, not on scientific evidence.

As we learn more about TMJ Disorders, many in the healthcare community are reassessing their treatments and ways in which they were developed. TMJ Disorders are now more commonly recognized as occurring simultaneously with other other types of pain conditions than in the past. It is possible for treatment to involve more than one area of specialty.

Due to these reasons, The TMJ Association is unable to provide doctor referrals at this time.

So whom should you see for a TMJ problem? We suggest you initially consult your primary care physician to rule out any other illnesses as the cause of your symptoms. If your physician does not diagnose a medical condition, and you are referred to another healthcare provider, it is suggested you obtain several independent opinions to confirm your diagnosis prior to committing to any treatment.

Most often TMJ patients experience pain. Perhaps a specialist who specifically treats cancer and chronic pain conditions may be able to work more specifically with your pain levels, trying out several medications in an attempt to achieve the maximum result with the least side effects. The NIH Technology Assessment Conference concluded that without appropriate scientific research, present treatments run the risk of worsening an existing condition. It was emphasized that pharmacological strategies and therapies need to be utilized to alleviate TMJ-related pain. The authors noted, "the principles for management of the pain associated with persistent TMD are the same as those for treatment of other chronic pain conditions. Opiates and NSAIDs (non-steroidal anti-inflammatory drugs) are recognized as mainstays for analgesic management and should be implemented commensurate with the level of pain."

The TMJ Association

The TMJ Association is dedicated to improving treatments for TMJ patients and, ultimately, discover effective cures and prevention for these disorders. That's why we work to identify and advocate for the research with the best chance of success. We define success as significant progress in the following two areas:

1. Research leading to a greater understanding of TMJ disorders.
2. Safer and more effective methods of diagnosis and treatment, based on scientific evidence.