Mouth Guards & More Aggressive Treatment

Simple, gentle therapies are usually recommended first. If those don't work, mouth guards and more aggressive treatments may be considered. Surgery is generally considered a last resort. Fortunately, there are many steps you can take at home long before that point.

Try massaging the various muscles that may be involved. Probe all of the muscles of the face, shoulders, and back of the neck. (Avoid the area around the throat.) Press on the muscles to identify extremely painful points. Massage the painful spot with hard, slow, short strokes. Do this several times a day until the muscle is no longer painful when pressed.

To massage the masseter muscles on each side of your jaw, place your thumb inside your mouth and squeeze the thick muscle in your cheek (toward the back of your mouth) with your fingers. To get at the harder-to-reach jaw muscles inside your mouth, use your index finger to probe for tender areas behind the teeth, and use the finger to massage these spots.

Here are some other steps to consider:

* Maintain good posture while working at a computer, watching TV, and reading. Take frequent breaks to relieve stressed muscles.
* Make a habit of relaxing your facial and jaw muscles throughout the day.
* Avoid eating hard foods, like nuts, candies, and steak.
* Drink plenty of water every day and get plenty of sleep.
* Learn relaxation techniques to reduce overall stress and muscle tension in your back, neck, and body.

Other home-care therapies are useful for some people, such as moist heat or cold packs on the face, vitamin supplements, or biofeedback. Exercising several times each week may help you relax, strengthen your body, increase flexibility, and increase your pain threshold.

Read as much as you can, as opinion varies widely on the management of TMJ disorders. Get several clinical perspectives. The good news is that most people eventually find something that helps.

MOUTH GUARDS

Mouth guards, also called splints or appliances, have been used since the 1930's to treat teeth grinding, clenching, and TMJ disorders. Many people have found them to be useful, but the benefits vary widely. The guard may lose its effectiveness over time, or when you stop wearing it. Other people may feel worse pain when they wear one.

There are different types of splints. Some fit over the top of the teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position, inhibit clenching, or provide some other function. If one type doesn't work, another may.

For example, a new type of splint is called the NTI-tss. It fits over just a couple of top, front teeth. The idea is to keep all of your back teeth completely separated, under the theory that most clenching is done by these back teeth. With the NTI splint, the only contact is between the tiny splint and one bottom front tooth.

MORE AGGRESSIVE TREATMENT

Be cautious about any non-reversible treatment method that permanently alters your bite. However, if a mouth guard doesn't work, your dentist may recommend orthodontics to help re-align your teeth.

Reconstructive surgery of the jaw is rarely required. In fact, studies have shown that the results are often worse than before surgery.

Muscle relaxant medications may help. Nonsteroidal anti-inflammatory medications (NSAIDS) help reduce inflammation in the jaw stemming from arthritis or other causes of inflammation.