TMJ Headaches
Temporomandibular disorders (TMDs) refer to a variety of issues that affect either the chewing muscles, the TMJ, and surrounding tissues.

The goals of the treatment of the temporomandibular joint disorder (TMD) are to reduce pain and restore normal function of the jaw.

Because the signs and symptoms of TMD could be transient and self-limiting, straightforward and reversible therapy should be preferred over complex and permanent procedures. These goals are accomplished by using a planned, time-limited treatment that addresses both the underlying physical problem and its contributory circumstances.

The five fundamental therapy modalities to get rid of temporomandibular joint headaches include:

  1. Patient education and self-care
  2. Cognitive and behavioral interventions
  3. Pharmaceutical management
  4. Physical therapy
  5. Surgery

What is the treatment for TMJ headaches?

  1. Patient education and self-care
    • Modifying simple habits related to the jaw can be beneficial, which includes the following:
      • Not eating anything chewy or hard
      • Minimizing stress to avoid coping mechanisms, such as clenching the jaw
      • Preventing jaw movements, such as those associated with yawning or chewing gum
      • Icing the jaw can help relieve pain
  2. Cognitive and behavioral intervention
    • Relaxation exercises, hypnosis, or biofeedback are frequently used in conjunction with behavior change programs. There are many different muscle relaxation training strategies. The technique used will depend on the patient and the therapist. This method generally eases or manages muscle pain.
  3. Pharmacologic management
  4. Physical therapy
    • In most cases, the purpose of treatment is to physically rehabilitate the joint by lowering joint inflammation, regaining joint mobility, and removing muscle pain through heat and stretching. Since Costen published his research on jaw joint pain in 1934, occlusal appliances have been the cornerstone of dental therapy for TMD.
    • Occlusal appliances are typically constructed of hard, heat-cured acrylic that covers the occlusal surfaces of either the upper or lower dentition. The possible advantages of using an occlusal device include reducing or eliminating teeth clenching and grinding, as well as relieving joint surface stress and relaxing the masticatory muscles. However, research has mostly failed to support these widely assumed methods of action.
    • A repositioning device often called a splint, is a different type of appliance that is less frequently employed. Its objective is to move the mandible forward or outward, which ought to help heal the inflamed discs' tissues. These tools are generally discouraged because they carry a danger of changing the bite.
    • Although the nociceptive trigeminal inhibition tension suppression system device is currently popular, there have been reports of incidences of aspiration into the lungs. Splint therapy is typically only necessary and safe during the day.
  5. Surgery
    • Most TMDs are self-limiting. Surgical intervention is rarely necessary.
    • Although joint injection with corticosteroid is routinely included in treatment plans, there is no research to back it up.
    • Studies have expressed concern about the potential for condylar damage from repeated corticosteroid doses. Practitioners are encouraged to restrict the use of this method for specific patients.
    • Joint irrigation (arthrocentesis) with lactated Ringer's solution or regular saline may result in improved jaw movement and decreased joint pain.
    • Arthroscopy allows for direct imaging of the joint surfaces more invasively than arthrocentesis. Both methods' efficacy to regain mouth opening is supported by evidence.
    • Though open-joint surgery is extremely rare, it could be required in extreme cases where the impairment caused by joint sickness has a significant impact on quality of life.

SLIDESHOW

Pain Management: Surprising Causes of Pain See Slideshow

What are TMJ disorders?

The term temporomandibular disorders (TMDs) refers to a variety of clinical issues that affect either the chewing muscles, the temporomandibular joint (TMJ), and surrounding tissues or both. Some people refer to this as temporomandibular pain disorder syndrome.

The symptoms of the syndrome are discomfort and pain in the chewing muscles, clicking sounds when the jaw opens, and restricted jaw movement. One in 10 people may experience TMJ pain, and nearly half of the U.S. population is diagnosed with TMD.

The research in this area has not yet distinguished between headache and facial pain. In investigations of nonpatient populations, three out of four people exhibit at least one symptom of joint dysfunction (clicking, limited range of motion) and about one in three have at least one sign (pain, pain on palpation).

Fewer than 1 in 20 people who have a sign or symptom need medical attention. Headaches are experienced as the main symptom in even people. Because headaches and TMD are so widespread, they could coexist or be distinct conditions. The TMJ and associated facial and mouth structures should be considered triggering or persisting factors for migraine.

How is TMJ disorder related to headaches?

The International Headache Society's classification committee developed criteria to identify temporomandibular disorders (TMDs).

Criteria for TMD to be described as headache or facial pain linked to a temporomandibular joint (TMJ) are:

  • Persistent pain in one or more regions of the head and/or face.
  • TMJ issues can be seen on an X-ray, MRI, or bone scintigraphy.
  • The association between pain and TMD is supported by at least one of the following:
    • Pain that flares up by chewing on hard foods and moving the jaw.
    • Jaw opening that is not normal or is less wide.
    • Jaw movement-related noise coming from either one or both TMJs.
    • Sensitivity in one or both TMJs' joint capsules.
  • The headache goes away after a successful course of medication in three months and does not come back.

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Medically Reviewed on 11/11/2022
References
Image Source: iStock image

Temporomandibular Joint (TMJ) Disorders. https://my.clevelandclinic.org/health/diseases/15066-temporomandibular-disorders-tmd-overview

TMJ disorders. https://www.mayoclinic.org/diseases-conditions/tmj/diagnosis-treatment/drc-20350945

Temporomandibular Disorders and Headache. https://americanmigrainefoundation.org/resource-library/temporomandibular-disorders/