Non Surgical TMD Therapy – Does TMJ treatment require surgery?

non surgical tmj treatmentIs surgery necessary to correct TMJ? No. There are many treatments to consider that correct TMJ and do not involve surgery.

TMJ pain is among the most serious conditions affecting your face, jaws and muscles involved in chewing and biting food. Early diagnosis and management of TMJ pain is essential for avoiding progression of the disorder and development of complications. Complete history and thorough check of TMJ and surrounding area is necessary before planning treatment of the problem.

What is TMJ pain disorder?

TMJ pain disorder is the condition in which your face and mouth suffers from pain and discomfort during talking, laughing, eating, drinking, chewing, biting, yawning and all activities involving muscles of the face and mouth. TMJ or temporomandibular joint is the joint which connects the jaw bones to skull. If you are having symptoms, you should consult with a qualified tmj dentist. How to know if TMJ surgery necessary?

Which is the major sign of TMJ dysfunction in addition to pain and discomfort?

tmj surgery necessaryTMJ disorder usually presents as pain and discomfort in the affected area of your face and mouth. In addition to feeling of pain, majority of TMJ cases are presented with popping and clicking noises when you open or close your mouth during talking, eating or chewing food. Clicks may occur during both opening and closing your mouth.

What are the major symptoms of TMJ pain disorder?

Following conditions are usually seen in patients affected with TMJ pain disorder,

  • Difficulty in opening your mouth in the morning when you wake up from sleep,
  • Locked jaws,
  • Soreness of mouth in the morning,
  • Tense/taut jaws,
  • Teeth grinding and clenching (bruxism),
  • Limited mouth and jaws movements,
  • Pain and discomfort during jaw movements i.e. both upside down and sideways,
  • Worn teeth,
  • Toothache,
  • Cracked and broken teeth in severe cases,
  • Previous history of multiple dental treatments i.e. root canal treatments, dental implants, teeth whitening, dental fillings, dental bridges and crowns,
  • Gum recession,
  • Bone loss around teeth,
  • Difficulty of breathing during night as the tongue falls back and blocks airway (sleep apnea),
  • Pain and discomfort on chewing and biting food,
  • Severe pain within and around your ears (earache),
  • Severe pain and discomfort in your temple area, behind eyes and back of the head,
  • Temporary loss of vision due to stress,
  • Flu and sinus irritation,
  • Chipping and cracking of teeth,
  • Pain and discomfort in shoulders, neck, head and back,
  • Problems in bite between upper and lower teeth,
  • Loss of appetite.


Surgical treatments in all cases of TMJ dysfunction necessary?

tmj surgery necessaryIt is not at all necessary to opt for surgical treatments in TMJ pain cases. Many non-surgical TMJ treatments are available and work. Surgical intervention is usually avoided at all costs as conservative and symptomatic treatments usually suffice and give excellent outcomes. In fact, majority of cases require conservative and non-invasive treatment planning. However, when your TMJ specialist has tried all non-surgical option or thinks severity of the disease required surgical procedures, these should be performed. Whenever surgical treatment is deemed necessary by the TMJ expert, it is usually performed in the least invasive manner possible.

Non-surgical treatments for TMD pain cases?

Majority of TMJ pain cases are treated with the help of self-management exercises at home and conservative treatments by the TMJ specialists. The course of treatment is usually guided by the cause of problem. Your TMJ specialist will evaluate the condition before planning treatment for you. The two treatments that can correct TMJ without surgery:

  • DNA Appliance Therapy
  • ALF Appliance treatment
  • other conventional treatments available:
  • Splint and occlusal guard treatment
  • Cognitive behavioral therapy which includes patient counseling, reassurance and education about the cause of TMJ pain,
  • Reversal/prevention of habits which damaging and aggravating TMJ pain,
  • Educating patients about exercises which will help in proper use of jaws during chewing, biting and eating,
  • Use of thermotherapy (both hot and cold) through moist heat pads and cold packs on painful and taut/strained muscles,
  • Physiotherapy techniques involving massaging painful muscles,
  • Stretching exercises for increasing limited mouth opening,
  • Co-ordination and mobilization exercises for achieving controlled jaw movements,
  • Physiotherapy should be started as soon as possible. It will provide best results in early course of treatment,
  • Use of soft stabilization splints,
  • Rest,
  • Ultrasound,
  • Trans-electric nerve stimulation (TENS) jaw muscles relaxation and reducing pain/discomfort,
  • Correction of disturbed jaw bite with the help of braces,
  • Botox injections,
  • Various medications for reducing pain, discomfort and anxiety which will help in the treatment of TMJ pain i.e. Non steroidal anti-inflammatory drugs (NSAIDs), Tri-cyclic anti-depressants (TCAs), anxiolytics, anti-epileptics and cortico-steroids,


Which lifestyle changes and precautions can help in the management of TMJ pain?

Your lifestyle and daily habits can be crucial in avoiding TMJ pain and discomfort. Your mouth functions throughout the day and needs rest as well. Following are very important for the prevention and management of TMJ pain.

  • Refrain from biting hard nuts and crunchy foods when you have TMJ discomfort,
  • Avoid taking sticky foods in this condition,
  • Taking soft diet will help in easing and relieving your TMJ pain,
  • Reduce stress and anxiety,
  • Avoid gum chewing,
  • Avoid sleeping on the affected side,
  • Avoid putting telephone cradle on the affected side,
  • Avoid wide yawning.


TMJ surgical treatment options for pain?

Surgery is advised by the TMJ specialists as a last resort when all non-invasive procedures fail and do not provide the anticipated results. However, least invasive surgery will be opted first and more invasive procedures will only be performed when all other options become irrelevant. Surgical procedures which can benefit for the treatment of TMJ pain disorder are,

  • Arthrocentesis is the least invasive surgery and you can go home on the same day following this treatment,
  • Modified condylotomy,
  • Disc re-positioning,
  • Discectomy,
  • Joint replacement.


TMJ Surgery Complications can occur during major surgery?

We aim to perform safe surgical procedures. You must go for an expert TMJ surgeon whenever it is planned to opt for surgical treatment. However, complications which can occur during surgery are,

  • Infection,
  • Bleeding problems,
  • Problems associated with general anesthesia,
  • Nerve or blood vessel damage,
  • Failure of surgical treatment.
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