Other Treatment Options for TMJ

Other TMJ Treatment Options Available at Austin Smile Creations

Injection Therapy

As long as we are dealing with muscle malfunction, several forms of injection therapy can be utilized. 

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Steroid injection

Overworked muscles often develop “trigger points”. These especially sore areas of the muscle feel like hard ball-shaped spots in the tissue that can be very tender to touch. By first numbing these spots and then injecting them with a steroid solution, it is possible to reduce the inflammation. In addition, through exercise and relaxation, sometime also using a variation of cold and heat packs, the initial “bump in the road” can be improved. A follow up with night time splints and eventual permanent bite corrections can render drastic improvement.

Dentox (Botox A) injection

The level of activity of specific muscles can temporarily be reduced by using Dentox judicially. A thorough exam as for a full-time splint is imperative. Misuse of this drug can temporarily cause undesired side-effects, such as reduced chewing ability and facial asymmetries. Dentox lasts for 4-6 months and the drug is very effective given in the right circumstances. The treatment needs to be repeated every 6 months to keep the TMD problem under control. It is a pain management strategy, but it does not solve the underlying problem of stress and tooth/jaw malalignment.


Laser Therapy

There is a large body of published clinical evidence for the effects of Low Level Laser Therapy (LLLT) on musculoskeletal pain. Systematic reviews published by the Lancet, BMJ, International Association for the Study of Pain show that LLLT improves the speed and quality of tissue repair, reduces inflammation and has an analgesic action. LLLT works well on a range of oral pathologies and is beneficial for orthodontic procedures and orofacial pain syndromes. We have had great success with this laser in our practice on Austin patients for TMD disorders as well as many other conditions. It is a fantastic new non-invasive and very effective way to relieve pain and discomfort as well as other TMD symptoms.


Physical Therapy / Chiropractic Manipulation

A component of TMD problems that is related to bad posture, spinal injuries and normal wear and tear relating to physical activity of different levels. Granted, people with a lot of accidents are more prone to residual problems than most. Any accident that can be described as a sudden impact relating to an accident or a sports-related injury certainly can be contributing to a life of muscle problems and joint malfunction. The possibilities are vast and the symptoms are often misdiagnosed. Thorough evaluations of postural problems by qualified professionals are very important and should never be overlooked. Dr. Gotun frequently involves other professionals to evaluate the general health of his patients. There is a wide variety of possible contributing factors and if ignored, the consequences can be devastating.



We live in a society that enjoys an enormous amount of effective drugs to help us cope with undesirable physical and mental problems. One of the sad facts of life is that many of them are not curing the problems but rather limiting the perception of the seriousness and the extent of the disease by an individual and thereby contributing to escalation of the problem by dulling the symptoms. For example, we can walk on a broken leg if we are under the influence of pain medication strong enough to hide the actual pain and original damage. But in spite of that, we also can, under proper supervision, use drugs to speed up healing and recovery.


Some of the best helpers if used over a short period of time are categorized in a group called the nonsteroidal anti-inflammatory drugs (NSAIDs). Some of these are Ibuprofen, Aspirin, Advil, Tylenol, Naprosyn
and many more.

NSAIDs can be broadly classified based on their chemical structure. NSAIDs within a group will tend to have similar characteristics and tolerability. There is little difference in clinical efficacy among the NSAIDs when used at equivalent doses. Rather, differences among compounds tended to be with regards to dosing regimens (related to the compound's elimination half-life), route of administration, and tolerability profile. Some more common examples are given below.

a. COX-2 inhibitors
b. Celecoxib (FDA alert [1])
c. Etoricoxib FDA withdrawn
d. Lumiracoxib TGA cancelled registration
e. Parecoxib FDA withdrawn
f. Rofecoxib (withdrawn from market [2])
g. Valdecoxib (withdrawn from market [3])
h. Sulphonanilides
i. Nimesulide (banned by several countries for the potential risk of hepatotoxicity)
j. Ibuprofen[4]
k. Naproxen
l. Diclofenac
m. Licofelone
n. Licofelone acts by inhibiting LOX (lipooxygenase) & COX (cyclooxygenase)and hence known as 5-LOX/COX inhibitor

To make a long story short: NSAIDs used for a short period of time to reduce inflammation and pain are a very useful tool, but used indefinitely, NSAIDs can cause all kinds of physical problems which might not show up immediately. Problems like upset digestive system and even cancer can develop in some circumstances. NSAIDs used in conjunction with the aforementioned therapies are known to drastically boost the healing speed.

Muscle Relaxers

Muscle relaxers like Diazepam (Valium) are in a group of drugs called benzodiazepines. When treating TMD, a small dose of the drug is taken right before bedtime. It helps people sleep and it drastically reduces muscle hyperactivity. Used over a short period of time, for instance 10 days, some of the stress-inducing TMD can be managed and healing can begin, in particular if it is used in conjunction with some splint or injection therapy. Diazepam used over longer periods is habit-forming and loses its therapeutic effect. It should not be used unless it is prescribed and supervised by a licensed professional.

Pain Medication

Drugs containing codeine or hydrocodone like Vicodin, Lorcet and the like are far from the treatment of choice. Generally the medication creates an altered perception of the pain and has no healing effect. These kinds of drugs should only be used in extreme cases where there is an overwhelming need to limit pain immediately for a short period of time.


Other Alternatives in TMJ Disorder Treatments

TMD has been a disease that has been around forever. People that complain about headaches often have a TMD component that is part of the trigger mechanism. Healthy living, good eating habits, reduction of stress and increase in exercise are important contributing factors to promote the healing. There are special relaxing exercises that can be helpful. Reestablishing good posture and awareness of how you sit and function in your day-to-day active life are a must. Also, studying your sleeping position and sleeping habits are part of finding out what can be improved to promote healing.

If you have any questions, concerns, or would like to schedule an appointment, please contact us at Austin Smile Creations.



Read what people are saying about us.

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If you are reading this testimonial, I assume you are looking to alleviate pain in one or more of your teeth or to improve your smile cosmetically. Either way you can save yourself some time, stop right now and go make an initial evaluation appointment with Dr.Gotun and his staff at their cozy, comfortable office with a relaxing peaceful view of Eanes Creek. You can search the 1200 or more listings in the Austin area and the BEST you could hope for would be to find another dentist equally as skilled and talented as Dr.Gotun. I do NOT think it is possible to get BETTER quality dental work than what you will get at this office.

The one thing that made everything so simple for me was the photographs. During the initial exam Dr.Gotun takes a series of photographs of your teeth along with x-rays. You then get to see your teeth on a laptop screen, in color, up close and larger than life. If you can live with what you see then you can count your blessings and Dr.Gotun will let you be on your way, unless of course you would like to schedule a cleaning!

In my case I could see the damage, decay and buildup from many years of poor oral hygiene and neglect. In addition to the problem teeth that brought me to the dental office I could easily see that most of my teeth were in need of some type of restoration work. Dr. Gotun has my permission to show all of my records to anyone interested in seeing them. I am sure you will be as amazed as I still am at what Dr. Gotun was able to accomplish considering the very poor condition my teeth were in at the start of the process.

The cost was substantial in my case due to amount of work that was required. However, the work was spaced out over several years which made the cost much easier to budget. Dr.Gotun was not on my dental insurance plan, so I accessed some savings and my credit to finance the work and paid it off like any other significant asset I have purchased. My teeth are the most rewarding investment I have ever made.

If I could give anyone one bit of advice other than my story, it would be “do NOT let dental insurance be the major factor that guides your decision-making”. I was never happy with any of the experiences or results I had when I tried to use the dentists that were covered under my plan. I am proof that 12 years on with regular flossing and brushing, the investment in your restoration work done by Dr.Gotun can still be yielding satisfaction and compliments from friends and random strangers.

I have never gone to bed without flossing and brushing after seeing those photographs in my initial visit. Good luck and I hope to be reading your success story here sometime in the future.

Chuck M. Austin, TX

Dr. Tor Gotun probably saved my life and he's added some years to it. You don't usually say that about your dentist, but I believe it in my case.

More than 10 years ago, after many years of neglecting my teeth and an unhealthy life style, I went to Tor, my neighborhood dentist, even though he wasn't on my State of Texas dental insurance network.

I soon learned of the challenges to getting my gums and teeth back to a healthy status. The way Tor explained it, I knew it was complex and that Tor had the skills and vision to get me there, as long as I did my part. I also knew it would take time and not be cheap.

Now, years later, I still have most of my original teeth and only a few very nice, state-of-the art crowns. I am following Tor's advice for taking care of my teeth and gums, including his regular cleaning schedule. What my dental insurance didn't cover, I was able to use Austin Smile Creations' association with Care Credit to finance the costs without any interest charges as long as I pay off balances within a year of each charge.

By the way, we had only one procedure that didn't work out as planned, but Tor made good on it and the solution turned out as good or better.

As a bonus, all of Tor's top flight members are both professional and personable, always considerate of my needs, interests, and schedule.

Bottom line, Tor is better than my expectations. He pays attention to more than just how my mouth looks; he's concerned about my overall health and how my life-style affects, and is affected by, the health of my teeth and gums.

Bill H. Austin, TX

I have been going to Dr. Gotun since he used to have his practice on William Cannon Drive ( 20 years now). Now he is located in Bee Caves. He is an excellent dentist.

The thing I like best about Tor Gotun is he is relatively pain free when administering his shots to numb your mouth. Dentists I have had before always seemed to be a bit heavy handed in this activity.

He is very up to date with modern dental technology. He can make a crown or cap in his office at the moment of your appointment and have you leave with a fully functioning mouth. I have friends who use other dentists who must wander the city of Austin for at least a week with a hollowed out molar stuffed with gauze as they await their topping to arrive by mail to their dentist's office.

The staff is very friendly, and Dr. Gotun will never talk down to you. He is very good at explaining why he is doing something or why he wants to do a procedure. He may have gotten two of my wisdom teeth, but I will still try to hold onto the remaining two regardless of his explaining the safety factors of hanging on to them as you get older.

Randy S. Austin, TX

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Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.