Acupuncture is centuries old medicine which has proven to be safe, effective and easy to incorporate for several diseases and disorders. While the exact mechanism is not known, it addresses multiple mechanisms of pain as well as quality of life in this frustrating disorder.

Acupuncture works well for:

Botulinum toxin (commonly known as Botox®) is an effective treatment for jaw and head pain. Botox® can help severe teeth grinding by reducing the frequency or intensity (or both) of jaw muscle contractions. It can also reduce pain in the region and studies have shown that it can reduce muscular as well as nerve pain.

Does Botox® fix TMJ disorders?
Each case is unique and there are certainly cases which respond well to only one treatment modality like Botox® while others require a synergy of modalities for the best effect. Some of the factors to consider when selecting the use of Botox® are:

Mouthguards come in various different shapes and colors and other unique features. Most commonly they are used to guard the teeth as the name suggests. When indicated for jaw pain or headaches, mouthguards are designed a little differently so they can help alter the mechanics of the jaw muscles and the joint. The exact mechanism by which they improve so many jaw symptoms is not well known but it is thought that a strong mechanism of mouthguard could be behavior modification. .

This is especially important as several patients think that because mouthguards improved their symptoms do dramatically, there is a problem with their jaw alignment. There is very little to no scientific proof that jaw alignment is to be blamed for common TMJ symptoms.

Our bite (Dental occlusion) is very dynamic and always adapting to the demands (functional demands, behavior demands, physiological demands of the surrounding tissues etc). The teeth and jaw bone structure is maintained in a harmonious position due to the force distribution between the maxilla and mandible and the relation of the upper and lower teeth allows the forces to be distributed in a specific pattern. Mouth-guards change the force distribution between the maxilla and mandible.

When using a mouthguard, there is always a risk that the mouthguard will redirect the usual forces of the bite (could be a good change or bad). We see bite changes more commonly in patients who are between ages of 10-25 and in patients who have a history of orthodontic treatment. There are ways to minimize unwanted bite changes from these mouth-guards; the most important thing to do is to have your dentist or a TMJ specialist check the mouthguard at least 2-3 times a year.

TMJ Arthrocentesis is an in-office procedure performed under IV sedation/general anesthesia. A small catheter is inserted into the joint. The joint is copiously irrigated with sterile saline and steroids. Results are excellent and relief is immediate.

Trigger point injections are used commonly for TMJ disorders and jaw spasms. For TMJ disorders, trigger point injections mainly focus on relieving and reducing muscle pain. Trigger points are taut areas in a muscle which commonly refers pain to a distant site. For example, trigger points in masseters or lateral pterygoid often refer pain to teeth and in several instances, the pain is ONLY present in a tooth or couple of teeth giving an impression of a tooth (dental) issue. Similarly, trigger points in pterygoid muscles can cause pain in the ear and trigger points in sternocleidomastoid and occipitalis can mimic headaches.

What medicine is used for trigger point injections? Depending on the diagnosis and location of the pain, local anesthetics (Lidocaine or Mepivacaine or Bupivacaine), steroids (Triamcinolone), Botulinum toxin (Botox, Xeomin or Dysport) are commonly utilized.

If the pain is due to a chronic TMJ disorder, trigger point injection often have to be repeated at 1-3 month intervals. Like any medicine, trigger point injections can have side effects. Having a detailed understanding regarding diagnosis and possible complication is key to avoiding side effects and maximizing benefit.