Alternatives to TMJ Treatments

Temporomandibular joint (TMJ) dysfunction impacts over 10 million Americans, causing pain, popping, or clicking in the joint; face and neck pain; headaches; difficulty chewing; irregularly worn down teeth; and constricted mouth opening.

What causes TMJ?

TMJ can be caused by several factors, or a combination of them, and so an integrative approach to supporting the body is often needed to reduce symptoms. TMJ symptoms may stem from misaligned teeth, clenching and grinding, arthritis, hormonal imbalances, as a symptom of a psychophysiologic disorder, or a trauma to the head. There are three characterizations of TMJ dysfunction: pain in the muscles that open and close the jaw, an issue with the joint, or inflammation and degeneration within the joint, such as from arthritis.

What does TMJ feel like?

TMJ dysfunction can cause a variety of symptoms. For instance, the jaw may have poor movement or may lock, click, pop, or grate in the joint. Sensitive teeth, abnormally ground-down tooth surfaces, bite and chewing problems, and restricted range of mouth opening may also result. Muscles controlling the jaw joint may be stiff, and the person may have pain in the face, neck, or jaw that radiates from the joint as well, including into the ear. These individuals are also more likely to experience tension headaches.

Approaches to managing TMJ

Allopathic treatment consists of pain relievers, consuming a soft foods diet, orthodontics, stress management, and finally surgery as a last resort. Meanwhile, an integrative approach leverages diet changes, supplements, lifestyle, and a variety of adjunct therapies to decrease inflammation and bring relief. 

Here are some different integrative and natural things to try to get some symptom relief: 

Dietary changes

-experiment with eliminating nightshades from the diet (peppers, potatoes, tomatoes, eggplants, and tobacco).
-consume omega-3 fatty acids through foods such as oily wild caught fish (salmon, mackerel, anchovies, sardines, herring), freshly ground flax and chia seeds, and nuts (especially walnuts) several times per week.
-choose softer foods, but make sure they are real, and not processed, foods! Pureed vegetables with butter or coconut oil, smoothies with vegetables and clean protein powders, and soups loaded with a variety of meats, veggies, or fish are all excellent choices.
–limit sugar intake by cutting refined sugars. Consume 2-3 servings of low glycemic fruits (green apples, berries) several times per day.
-spice your food up with herbs and spices, which are often anti-inflammatory. Some choices include turmeric rosemary, oregano, thyme, oregano, chili pepper, basil, and ginger. 

Supplements 

-high quality fish oil for additional omega-3 fatty acids, that has been tested free from heavy metals. One product is Nordic Naturals ProOmega 2000
–curcumin, such as Thorne Meriva 
–glucosamine, taken for a minimum of four months 
–frankinsense essential oil, diluted and rubbed on the joint
–ice for the joint during moments of pain

Lifestyle changes/stress management

–progressive relaxation to decrease muscle tension throughout the body. Instructions can be found here.
–stress management techniques to prevent jaw grinding, such as deep breathing.
–address your experience of pain by expressive writing, journaling, or making art about the experience; identifying gratitude in your life; developing a meditation practice; or creating visualizations of positive images to counter the pain.

Adjunct therapies – providers and alternatives to also consider

–nutritionist to ensure nutrient adequacy in promoting decreased inflammation.
–functional orthodontist to assess jaw alignment, support jaw expansions and movement, and help with bite.
–tongue and other tie releases when present, along with the support of a myofunctional therapist, functional orthodontist, and skilled bodyworkers, to release restrictions that might hold the jaw in poor alignment and stress the joint.
–prolotherapy, which has been found to alleviate pain symptoms, repair damage within the joint, and increase jaw motility.
–bodywork such as cranial sacral therapy, osteopathic manual manipulation, chiropracticts, myofascial manipulation, Rolfing, and other techniques.
–physical therapy exercises.
–cognitive behavioral treatment with a behavioral therapist to reduce experience of stress.

A combination of approaches is often necessary to reduce inflammation and keep it at bay, while addressing the structural issues within the joint itself.

References

Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2015). Effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders: Systematic review and meta-analysis. Physical Therapy, 96(1), 9–25. doi: 10.2522/ptj.20140548

Belcaro, G., Cesarone, M. R., Dugall, M., Pellegrini, L., Ledda, A., Grossi, M. G., Togni, S., & Appendino, G. (2010). Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Alternative Medicine Review, 15(4), 337–344. 

Majumdar, S. K., Krishna, S., Chatterjee, A., Chakraborty, R., & Ansari, N. (2017). Single injection technique prolotherapy for hypermobility disorders of TMJ using 25% dextrose: A clinical study. Journal of Maxillofacial Oral Surgery, 16(2), 226–230. doi:10.1007/s12663-016-0944-0 

National Institute of Dental and Craniofacial Research. (2018). TMJ (Temporomandibular joint and muscle disorders). Retrieved from https://www.nidcr.nih.gov/health-info/tmj/more- info 

Pizzorno, J.E. & Murray, M.T. (2012). Textbook of natural medicine (4th ed.). St. Louis, MO: Churchill Livingston. 

Rakel, D. (2017). Integrative medicine (4th ed.). USA: Elsevier.
Schultz, L.W. (1937). A treatment of subluxation of the temporo- mandibular joint [abstract]. 

Journal of the American Medical Association, 25, 1035–1037. TMJA. (2018). Occlusal (bite) adjustment. Retrieved from http://www.tmj.org/site/page?pageId=260