Pharmacotherapy
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Muscle relaxants
- Corticosteroids
- Anxiolytics
- Anti-depressants
- Topical analgesics
- Acetaminophen
Reference
Hersh EV, Oral Maxillofac Surg Clin North Am, 2008
Occlusal Appliance Therapy
Mechanism of action
- Alter TMJ structural relationships
- Reduce muscle activity
- Largely unknown
Recommended use
- Teeth clenching / grinding (bruxism)
- Pain and / or dysfunction associated with TMD (joint and / or muscles)
Side effects and interactions
- Tooth discomfort
Clinical implications
- Minimize tooth wear due to bruxism
- Decreased pain associated with TMD
- Increase TMJ function
- Increase jaw function and / or range-of-motion
Reference
Klasser GD, et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009
Physical Therapy
Mechanism of action
- Physical manipulation of structures of the TMJ complex
- Manage causative and perpetuating factors of TMD
- Enhance central inhibition
Recommended use
- Pain and / or dysfunction associated with TMD (joint and / or muscles)
Side effects and interactions
- Increased pain and / or dysfunction
Clinical implications
- Decreased pain associated with TMD
- Increase TMJ function
- Increase jaw function and / or range-of-motion
Reference
Gradd-Radford SB, et al. Oral Maxillofac Surg Clin N Am, 2016
Trigger Point Injections
Mechanism of action
- Mechanical disruption to inactivate muscular trigger points
Recommended use
- Pain and / or dysfunction associated with TMD (muscles)
Side effects and interactions
- Nerve dysfunction and / or damage
- Syncope
- Anaphylaxis
- Hemorrhage
- Infection
Clinical implications
- Decreased pain associated with TMD
- Increase jaw function and / or range-of-motion
References
- Lavelle ED, et al. Anesthesiol Clin 2007
- Robbins MS, et al. Headache, 2014
- Gradd-Radford SB, et al. Oral Maxillofac Surg Clin N Am, 2016
Complimentary/Alternative Medicine
Mechanism of action
- Address biopsychosocial aspects of TMD
- Address symptoms related to physical structures of TMD not responding to traditional conservative therapies
Recommended use
- Pain and / or dysfunction associated with TMD (joint and / or muscles)
- Biopsychosocial management of TMD
Side effects and interactions
- Dependent upon specific treatment / therapy
Clinical implications
- Decreased pain associated with TMD
- Increase TMJ function
- Increase jaw function and / or range-of-motion
Reference
DeBar LL, et al. J Orofac Pain, 2003
Invasive Procedures
Mechanism of action
- Physical manipulation of internal TMJ structures
Recommended use
- Failure of conservative therapies
- Intractable pain
- Significant functional limitation
Side effects and interactions
- Various (depending on procedure)
Clinical implications
- Decreased pain associated with TMJ internal derangements
- Increase TMJ function
- Increase jaw function and / or range-of-motion
Reference
De Rossi SS, et al. Med Clin N Am, 2014