Orofacial Pain, TMJ Disorders & Dental Sleep Medicine Specialists

Self-Care

Resting the jaw, soft foods, stress management, good posture, and TMJ awareness routinely help alleviate some of the symptoms. A simple consultation with a specialist helps.

Medications

These range from OTC NSAIDs like Ibuprofen or Acetaminophen to various muscle relaxants and other prescription medications as well as short term corticosteroids. These are typically prescribed for short-term relief only.

TMJ Splints

There are custom made oral appliances that help in realigning your jaw and preventing jaw clicking/popping or locking. There are many types and the diagnosis of TMD is particularly important for the correct management of your condition. Studies have shown that many times patients wear the wrong appliance, including nightguards, that makes the TMJ pain typically worse after being worn for only a few weeks.

Physical Therapy

We work with therapists to educate about your condition and help improve jaw mobility and range of motion. These may include manual therapies such as massaging, stretching, as well as Transcutaneous Electric Nerve Stimulation. At times we recommend Myofunctional Therapy, a specialized form of physical therapy for the muscles of the face, mouth, tongue, and jaw that aims to address the underlying muscular imbalances and dysfunctional habits contributing to TMJ pain and dysfunction.

Injections

There are a variety of injections that TMJ specialists use that have shown great results depending on the TMJ issues. Common ones include:

Trigger Point Injections:

Injecting medication to break the muscle knots in your jaw muscles. Detailed information is on our Myofascial Pain page.

Botulinum Toxin Injection, e.g., Botox/Xeomin:

Botox and Xeomin, commonly known as wrinkle reducers, are also powerful medical treatments for various functional problems, not just cosmetic ones. These include migraines and chronic headaches, overactive bladder, muscle spasticity, and increasingly, jaw muscle pain (such as severe teeth grinding and TMD, or Temporomandibular Disorders). For headaches, the injections work by blocking pain signals and relaxing the muscles. The medication is a neurotoxin that works by being injected into the muscle, temporarily blocking nerve signals to reduce hyperactivity. This controlled relaxation helps stop muscles from overworking, which breaks the cycle of chronic jaw pain. While the naturally-occurring toxin can be dangerous in large amounts (causing botulism), the tiny medical dose used is safe and effective. Patients typically feel the effects within a few days to a couple of weeks, with relief generally lasting about three to four months. If your symptoms are severe, your doctor may recommend more frequent injections.

Regenerative Injection Therapies:

Platelet-Rich Fibrin (PRF) injections are minimally invasive treatment options for TMJ disorders and other orofacial pain conditions. PRF is the latest 2nd generation Platelet Concentrate that utilizes your own blood to release natural growth factors and promote natural healing and tissue regeneration, including helping to heal the TMJ disc. The treatment involves collecting a sample of blood from the patient and processing it in Special Centrifuges made for PRF to separate out the platelets and fibrin, which are then re-injected into the treatment area. The platelets in PRF contain growth factors that help to stimulate the body’s natural healing processes, including TMJ Disc and surrounding Joint complex while the fibrin helps to create a scaffold for new tissue to grow on.

Numerous clinical studies have shown that PRF treatment can be effective in promoting healing and tissue regeneration, and it is considered a safe and effective procedure. We utilize PRF in the TMJ to encourage healing, prevent arthritis, and reduce inflammation.

Hyaluronic Acid a.k.a. Visco Supplementation:

This may be a treatment option for TMJ inflammation, degeneration, or reduced lubrication.

Proliferation Injection Therapy a.k.a. Prolotherapy:

This injection is a combination of dextrose or saline, a local anesthetic which helps stabilize the TMJ, improves its range of motion, helps prevent dislocation in a hypermobile joint, and also relieves pain.

Biofeedback Therapy

Biofeedback therapy of TMJ involves the use of sensitive electronic instrumentation to monitor and provide real-time physiological data, encompassing parameters such as heart rate, muscle tension, and peripheral skin temperature. This therapeutic modality has demonstrated clinical efficacy in the management of various pain syndromes, including but not limited to orofacial pain, migraines, and tension-type headaches. Furthermore, biofeedback is an effective intervention for addressing comorbid conditions such as anxiety and stress, which frequently contribute to or exacerbate pain symptomatology.

Photobiomodulation

Photobiomodulation (PBM), also known as red light or low-level laser therapy, is a non-invasive treatment for Temporomandibular Joint (TMJ) disorders. PBM uses specific wavelengths of light to reduce inflammation, stimulate cellular repair, and alleviate pain, improving jaw function and overall well-being for individuals with TMJ issues.

Transcutaneous Electrical Nerve Stimulation (TENS)

TENS therapy is a non-invasive neuromodulation technique employed for pain management. This therapeutic modality involves the transdermal application of pulsed biphasic electrical currents via surface electrodes. The underlying mechanism of TENS-induced analgesia is hypothesized to involve both gating mechanisms within the spinal cord and the release of endogenous opioids, thereby mitigating nociceptive signal transmission. TENS is recognized for its favorable safety profile and rapid onset of pain attenuation, circumventing the systemic adverse effects associated with pharmacological interventions.