Other TMJ Treatment Options Available at Austin Smile Creations
As long as we are dealing with muscle malfunction, several forms of injection therapy can be utilized.
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.
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 releave pain and discomfort as well as other TMD symptoms.
Physical Therapy / Chiropractic Manipulation
A component of TMD problems that is related to bad posture 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 results 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 )
c. Etoricoxib FDA withdrawn
d. Lumiracoxib TGA cancelled registration
e. Parecoxib FDA withdrawn
f. Rofecoxib (withdrawn from market )
g. Valdecoxib (withdrawn from market )
i. Nimesulide (banned by several countries for the potential risk of hepatotoxicity)
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 like Diazepam (Valium) are in a group of drugs called benzodiazepines. When treating TMD, a small dose of the drug is taken right before bed time. 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.
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.
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.