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Posts for tag: tmj disorders

By Dr. Rosanne M. Palermo
May 08, 2021
Category: Oral Health
Tags: tmj disorders  
WhatWeCanLearnFromThoseWithChronicJawPainandDiscomfort

Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.

But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.

A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.

Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.

Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.

The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.

These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.

If you would like more information on TMD management and treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”

By Dr. Rosanne M. Palermo
February 05, 2017
Category: Dental Procedures
Tags: tmj disorders  
KnowtheFactsBeforeConsideringBotoxforJawJointPain

If you have chronic jaw joint pain you may have heard of using Botox to relieve discomfort from temporomandibular disorders (TMD). Before you seek out this remedy, though, be sure you know the facts beforehand.

TMD is actually a group of conditions affecting the joints, muscles and overall structures of the jaw. People with TMD often experience sharp pain and reduced range of motion of the jaw joints. Although we don't know the exact causes, we believe stress (accompanied often by teeth grinding habits) is a major factor for many patients.

Treatments run the spectrum from conservative to aggressive. Conservative treatments include cold and heat packs, therapeutic exercises, and muscle pain or relaxant medication. On the more aggressive side, patients undergo surgery to reorient the lower jaw. Most people gain a significant amount of relief from conservative therapies; the results aren't as positive with surgery.

Botox falls on the aggressive side of treatments. Approved for use by the Food and Drug Administration for cosmetic uses, the drug contains botulinum toxin type A, a bacterial toxin that can cause muscle paralysis. It's often injected into facial structures to paralyze small muscles and temporarily “smooth out” wrinkle lines. Only recently has it been proposed to help relieve jaw pain.

The jury, however, is still out on its effectiveness with jaw pain. The double-blind testing performed thus far hasn't produced any relevant clinical results that the injections actually work with TMD.

And there are other complications. Some people injected with Botox encounter pain, bruising or swelling at the injection site, and some have severe headaches afterward. Botox is also a temporary solution, not a permanent cure — you'll need another injection a few months later to maintain the effect. You might even develop antibodies that diminish the drug's effect and require higher subsequent doses to compensate.

This and other concerns should give you pause before seeking out this remedy. The best strategy is to try the traditional treatments first, which are also the least invasive. If there's no significant relief, then talk to us and your physician about other options.

If you would like more information on treatment options for TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Botox Treatment for TMJ Pain.”