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The 4 Best TMJ Pain Relief Treatments

One of the biggest issues I hear about daily is patients complaining of muscle pain (both in the head and neck), tension at the temples, headaches, joint pain, popping and clicking. You might have heard the term “TMJ” problems. This stands for temporomandibular joint disorders, which can present with different symptoms. The most common factors that cause TMJ symptoms are nighttime clenching and grinding of the teeth. This puts a lot of pressure on the teeth and the muscles, causing the muscles to spasm and overwork. The masseter muscles are the ones directly at the angle of the lower jaw and they connect upwards to the temples, which can trigger both tension headaches and migraines. Sometimes patients also do daytime clenching and grinding, especially when they are focused on something else like driving or working at the computer. We tend to hold a lot of tension in our teeth and high stress is the number one contributing factor! Who would have thought…high stress in the DMV area… 😊

These are the treatment options:

1) Orthodontics! Correct or improve the bite of the teeth with Invisalign or braces. If the bite is not aligned well, then there is uneven pressure among certain teeth, which causes the muscles to spasm more. While this can certainly improve symptoms it will usually not completely resolve or get rid of the clenching and grinding. The biggest problem with grinding and clenching if the bite is not ideal is fracturing of teeth, chipping teeth, and gum recession due to heavy pressure. I correct a lot of deep bites after the teeth have already broken so come see me sooner to prevent issues.

2) Nightguard. About half of my adult patients and many older teen patients need a nightguard. I cannot tell you how many nightguards I make a week. A nightguard is a custom-made thick piece of thermoplastic material that has about a 1.5 mm thickness at the back teeth. This thickness (in theory) doesn’t allow the muscles to clamp down as much and should reduce clenching. A professionally made nightguard is also equilibrated, meaning that all the teeth are touching evenly and the pressure is evenly distributed. I do not recommend an over-the-counter guard or one you mold yourself online. The online bought ones have "chewy" material that is not hard on the surface. This can cause more grinding and clenching – like a doggie chew toy. Also, I have had to correct a lot of side effects of the bite, like bite opening, if the guard is not properly fitted. Give us a call today to schedule a scan appointment if you need a guard: 703-774-3070.

3) Botox. Botox is a muscle relaxant and helps to relax the masseter muscles so that patients are not able to clench and grind. This is an immediate fix and can be life-changing for relieving muscle pain and headaches. The downside is the cost, since about 60-80 units are required, and botox will wear away over the course of 3-6 months. I am certified by Aesthetic Medical in dental specific botox. This came out of personal necessity and since so many of my patients need additional treatment options. Our patient testimonial about TMJ botox. Shoot me an email and I can give you more information about what to expect at the appointment:


4) Massage. This temporarily will help with spastic muscles. You need to ask specifically for a head massage since they will then massage the temporalis muscles and the smaller muscles connected to the neck.


The best ways to combat a TMJ pain episode when the muscles are very spastic and painful is to do the 4 treatments above at once. Get nightguard, botox, massage, and fix the bite! Always reach out to me if I can help in any way!


Happy de-stressing,

Dr. Crissy Markova


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