![]() ![]() However, open-joint surgery involves more risks than other procedures do and should be considered very carefully, after discussing the pros and cons. If your jaw pain does not resolve with more-conservative treatments and it appears to be caused by a structural problem in the joint, your doctor or dentist may suggest open-joint surgery (arthrotomy) to repair or replace the joint. It may be helpful for treatment of pain and if locking is experienced. Modified condylotomy (kon-dih-LOT-uh-mee) addresses the TMJ indirectly, with surgery on the mandible, but not in the joint itself. TMJ arthroscopy has fewer risks and complications than open-joint surgery does, but it has some limitations as well. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted and small surgical instruments are used for surgery. In some cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders. In some people, corticosteroid injections into the joint may be helpful. Arthrocentesis (ahr-throe-sen-TEE-sis) is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts. When other methods don't help, your doctor might suggest procedures such as: With arthrocentesis, tiny openings are inserted into the TMJ so that fluid can be flushed through the joint to remove debris. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails. ![]() Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Along with exercises to stretch and strengthen jaw muscles, treatments might include ultrasound, moist heat and ice. Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well-understood. Oral splints or mouth guards (occlusal appliances).Nondrug therapies for TMJ disorders include: These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders created by muscle spasms. These medications, such as amitriptyline, are used mostly for depression, but in low doses, they're sometimes used for pain relief, bruxism control and sleeplessness. ![]() If over-the-counter pain medications aren't enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers for a limited time, such as prescription strength ibuprofen.
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