Can TMJ be fixed without surgery? Non-surgical TMJ Treatment Options

A non-surgical TMJ treatment approach is more conservative and is based on the unique needs of each patient.

They involve more general procedures that don’t require the recovery time needed after a TMJ surgery. Often, individuals are unclear where to turn for help with jaw pain or TMJ symptoms. The question is often asked, “Can TMJ be fixed without surgery?” Fortunately, there now is an official title designation that is recognized as an orofacial pain specialist. The emerging field of orofacial pain was considered and accepted by the American Dental Association (ADA) for full status as a new dental specialty.

Today, people suffering from jaw pain can seek an orofacial pain specialist for non-surgical options. This article will answer some common questions and offer hope that you can avoid surgery. Although this pain condition may be more effectively cared for when physical therapists and pain specialists are involved early on, sometimes surgery is necessary.

Does TMJ typically require surgery?

You may not need surgery at all if initial, nonsurgical therapies, medications, or lifestyle changes relieve your TMJ pain. Surgery is often the last resort for more persistent cases, and even that doesn’t guarantee a cure. Let your pain care provider know if your conservative treatments aren’t helping or if your symptoms are getting worse. At that point, a TMJ surgery involving replacing or repairing part of the jaw to treat temporomandibular joint issues may be considered.

A trained orofacial pain specialist may be able to help you resolve TMJ concerns before or without a need to consider surgical options.

“In many cases, the pain and discomfort associated with TMJ disorders are temporary and can be relieved with self-managed care and non-surgical treatments. Since the TMJ is a joint, with tissue and muscle, like any other in the body, the treatments are similar to how you would treat any other inflamed muscle or joint – with rest and relaxation.” – Dr. James Fricton

The goal of treatment is the elimination or reduction of pain and a return to normal temporomandibular joint function. The MN Head and Neck Pain Clinic believes that the initial treatment should be non-invasive and conservative, not surgical.

We start by diagnosing if a hidden TMJ issue is present. Because surgery is invasive, more expensive, and often not necessary, other treatment options should also be your first approach. This may include physical therapy for the jaw, orthodontics, restorative dentistry, and other healthcare approaches to gaining pain relief.

If you are experiencing TMJ neck pain or jaw pain, pain itself is a helpful clue. Change happens when we go through pain — if we pay attention and get the help needed from a TMJ specialist before it becomes a bigger problem. In this way, pain is good because it signals the need to take action.

You pain specialist understands how your trigeminal nerve may be associated with your TMJ pain.

What is Non-surgical TMJ Treatment?

If your jaw disorder is related to a misalignment, your pain specialist or dentist may recommend physical therapy for the jaw area, orthodontic treatment, such as a jaw splint, braces, or a TMJ retainer. These jaw treatments can realign your smile for a more comfortable bite which, in turn, can address your symptoms.

Typically, your TMJ treatment can start with specific self-care exercises or an orthotic (a custom-fit mouth appliance) device, which will help correct your bite. Many patients report that they gain pain relief with orthotics.

Temporomandibular Disorders (TMJ) and Physical Therapy

Treatment options for pain patients can be confusing and be expensive without good guidance. Physical therapy can be both inexpensive and effective treatment for patients with TMD. Physical therapy for the jaw goes beyond having an ultrasound and doing self-help exercises. A physical therapist specialized in treating TMJ does a lot more. They have a range of techniques to draw from ranging from manual therapy, manipulation, postural retraining, iontophoresis, ASTYM, soft tissue mobilization techniques, and guided relaxation.

TMJ Splint Therapy

Occlusal jaw splints are removable artificial occlusal surfaces that may assist the relationship of the mandible to the maxilla. They may be useful for either TMJ diagnosis or therapy. They do this by restoring the vertical aspect of occlusion, occlusal disengagement, joint unloading, masticatory muscle relaxation, or TMJ repositioning.

These jaw appliances are typically made of either hard or soft acrylic resin. After diagnosis, we may recommend an occlusal appliance to assist in muscle relaxation or to help reduce muscle activity. By monitoring the use of a splint to relax the elevator muscles, provide stabilization, and/or redistribute occlusal forces, pain levels may subside. Inhibiting bruxism may be achieved by the use of a stabilization splint. Additionally, rather than trying surgery early on, it is useful to examine the contact between the teeth for the muscles and possible TMJ triggers.

It is often effective to focus on reducing abnormal muscle activity that impacts the jaw. Non-surgical TMJ treatments often produce neuromuscular balance. Most pain patients find that they need to wear the splint at night; it’s best to check with your pain management team. More severe temporomandibular joint problems may lead to surgery.

Resolving TMJ issues may also helps with sleep apnea problems.

When is Seeking Professional TMJ Care Recommended?

The MN Head & Neck Pain Clinic recommends that a pain specialist be consulted if the following occur:

Unusual jaw pain levels and TMJ flare-ups.
If your range of jaw motion becomes restricted.
When normal activities like chewing and yawning trigger jaw pain.
If clenching or grinding your teeth triggers head and neck pain.
If you can’t open or close your jaw completely.
After an injury that includes a blow to the jaw.
When whiplash causes headaches to start up following a car accident, sports-related injury, or a fall.

Before surgery would be considered, less intrusive treatments may work to adjust problems caused by tooth grinding. In the case of combining jaw stretching exercises with a stabilization splint, some surface points may realign because the lower jaw will adopt a new position. When the goal is achieved of getting your masticatory muscles to relax into a consistent jaw relationship, your TMJ pain may only need to be reviewed at regular intervals. This process commonly takes between two to three months.

Investigations are required to not only eliminate the possibility of other pathological processes that may mirror temporomandibular disorder symptoms but also to decipher if there is cause and effect specifically related to the TMJ. Plain X-rays of the temporomandibular joint are useful as baseline investigations for detection of any traumatic changes in the jaw’s ability to function. In recent years, magnetic resonance imaging has increasingly been used in the investigation of the status of the jaw disc to determine if there is internal derangement of the temporomandibular joint. Cone-beam CT-scans are becoming more cost-effective and are extremely useful in showing high-resolution images revealing the presence of pathology.

Non-surgical TMJ Treatment Looks to Treat Underlying Causes

There is not be one standalone treatment in the management of jaw pain.

Non-surgical TMJ treatment looks to treat underlying causes for lasting relief from
Temporomandibular joint (TMJ) disorders. When left untreated, they can lead to severe and far-reaching issues. Patients who opt to undergo surgical treatment to relieve jaw pain symptoms may only treat the side effects, and require significant time for recovery.
Our pain care team believes in the approach of initially providing the most conservative care possible. For this reason, we provide non-surgical TMJ treatment at our Minnesota offices. Our goal is to relieve the symptoms associated with TMJ disorders (TMD) by gently treating the underlying cause.

“Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment. Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment may be all that is necessary to relieve discomfort.

Surgical treatments are controversial, often irreversible, and should be avoided where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Additionally, surgical replacement of jaw joints with artificial implants may cause severe pain and permanent jaw damage. Some of these devices may fail to function properly or may break apart in the jaw over time.

Persons undergoing multiple surgeries on the jaw joint generally have a poor outlook for normal,
pain-free joint function. Before undergoing any surgery on the jaw joint, it is extremely important to get other independent opinions and to fully understand the risks.” – TMJ (Temporomandibular Joint & Muscle Disorders) and Less Is Often Best In Treating TMJ Disorders by NIH

TMD and Surgical Treatment

Some doctors may recommend surgically helping the jaw’s cushioning disc that slipped out of place. Quite often the structure of the joint is sound, but the nearby muscles and ligaments have become inflamed. In our experience, this inflammation may be effectively reduced with non-surgical treatment. At times, Fibromyalgia is a condition that impacts the jaw; patients who experience widespread muscle and joint pain throughout their body along with fatigue should have this checked out.

Before scheduling a TMJ jaw surgery, take the less aggressive approach. Begin with easy, self-care practices such as eating soft foods, applying ice packs, and avoiding intense jaw movements. This is as simple as avoiding giant-size yawns and gum-chewing habits. Short-term use of modest over-the-counter or prescription pain medicines may provide sufficient relief.

If you do need surgery for a TMJ disorder, expect that the surgery will be performed by an Oral and Maxillofacial Surgeon, preferably one with surgical experience and skills in TMJ. TMJ arthroscopy (keyhole surgery) involves fewer risks and complications than open-joint surgery does but has some limitations as well. Some people with TMJ disorders may benefit from surgical treatment if severe enough and more conservative approaches have already been pursued.

What sets Non-surgical TMJ Treatment Apart from TMJ Surgeries?

Most TMD patients benefit from non-surgical care. These approaches often produce progressive positive results. If pain and discomfort begin due to misaligned jaws, higher levels of pressure are placed on the joint. In many cases, an oral appliance can shift jaw alignment so the jaw joint is less stressed. We know that preventing clenching and grinding of teeth can be achieved without surgery. This in turn can eliminate the cause of TMJ disorders.

Therapeutic jaw exercises are based on an understanding of how opposing muscle groups in the head, neck, and jaw region may not be working as intended. Static contraction of the masseter muscle produces a decreased sensitivity to painful stimuli; a finding that indicates that jaw exercises can activate a person’s healing abilities, according to the Journal of Oral & Facial Pain and Headache, 2020.

The source of these jaw aches and pains may be related to one or both of a person’s temporomandibular (TM) joints. Functioning from each side of the head, these joints normally work wondrously in synchrony, with a complex system of muscles, ligaments, discs and bones, to make different movements for chewing and speaking. Many patients find that Myofascial Release Treatment is effective for TMJ pain. As you can see, our human bodies are amazingly complex and deserve the diagnosis of an orofacial specialist when pain persists.

Erik lindfors DDS Phd, Senior consultant, Specialist in Stomatognathic Physiology, Uppsala, Sweden, states “There is a high need for orofacial pain/TMD specialists and a majority of the GPDs wants the specialists to offer continuing education in TMD.”
In the article Effectiveness of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain: A Randomized Control Study accepted June 1, 2020, he reports: “In the jaw exercise group the overall mean reduction of pain intensity was 76% at rest and 62% during jaw movement.”

What are the Benefits of Non-surgical Temporomandibular Joint Treatment?

The top benefits of non-surgical temporomandibular joint treatment are that it’s easier, more cost-effective, and gives you chances of a faster recovery.

To establish an effective treatment plan, we first gain a detailed knowledge of how your jaw joint works. Then your TMJ function treatment plan will be tailored just for you. We may guide you in your self-care as a first-line treatment modality. While no one broadly accepted standard on what constitutes self-care exists, our consultations align with proven results and general advice about methods of reducing strain on the temporomandibular joint, addressing psychosocial stressors, and providing individualized education/support.

For qualified pain patients, non-surgical TMJ treatment is often as successful as more aggressive care – and sometimes more so. You may enjoy improved oral function, increased physical comfort, and lasting jaw/muscle improvement that avoids future issues. Active and passive jaw exercises, postural exercises, and neck exercises consistently appear to have favorable effects for patients with Myofascial pain.

Of interest is a June 2015 NIH report that says, “After 1-year follow-up, 27.6% of the patients in the splint group and 37.5% of the patients in the control group reported ‘very good’ treatment effects. The findings of this study did not show stabilisation splint treatment to be more effective in decreasing facial pain than masticatory muscle exercises and counseling alone in the treatment of TMD-related facial pain over a 1-year follow-up”. Oral Rehabil at PubMed

The non-surgical treatment of temporomandibular disorders continues to be the most effective way of managing over 90 per cent of patients, according to Ahmad M, Schiffman EL in his article titled Temporomandibular joint disorders and orofacial pain. He continues by saying, “It is critical to point out that surgery has no role in the management of patients with chronic pain syndrome or muscular problems that do not involve the joint itself”.

SUMMARY: Request a TMJ Evaluation

To sum it up, in most cases people suffering from jaw pain issues can be treated without relying on opioids or surgery. It is important that input from all members of your TMJ specialist team are carefully considered so that the various treatment modalities can be specifically tailored to each and every patient.

Non-surgical treatment for this jaw condition is an easy way to improve your overall quality of life by obtaining a non-surgical TMJ treatment plan. Contact our office to obtain more information and to find out how our pain specialists may be right for you.