Therapy for Temporomandibular Joint Disorders (TMD)

What is TMD?

Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn. Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD). 

TMD often causes severe pain and discomfort. It can be temporary or last many years. It might affect one or both sides of your face. More women than men have it, and it’s most common among people between the ages of 20 and 40.

Common symptoms include:

  • Pain or tenderness in your face, jaw joint area, neck and shoulders, and in or around the ear when you chew, speak, or open your mouth wide
  • Problems when you try to open your mouth wide
  • Jaws that get "stuck" or "lock" in the open- or closed-mouth position
  • Clicking, popping, or grating sounds in the jaw joint when you open or close your mouth or chew. This may or may not be painful.
  • A tired feeling in your face
  • Trouble chewing or a sudden uncomfortable bite -- as if the upper and lower teeth are not fitting together properly
  • Swelling on the side of your face

You may also experience toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and ringing in the ears (tinnitus).


Topical Solutions

Transdermal application of NSAIDs such as ketoprofen results in significantly higher tissue levels beneath the site of application than are achieved with oral administration. Additionally, side effects such as gastrointestinal irritation are avoided.

The following article concludes: “topical non-steroidal anti-inflammatory drugs are effective in relieving pain in acute and chronic conditions.”

BMJ 1998;316:333

The following article reports “the systemic concentrations of ketoprofen have also been found to be 100-fold lower compared to tissue concentrations below the application…topically applied ketoprofen thus provides high local concentration below the site of application but lower systemic exposure.”

Pharm Res. 1996 Jan;13(1):168-72

Iontophoretic Solutions

Iontophoretic delivery (a method used to improve drug penetration by the means of electrical currents) of dexamethasone and lidocaine may be effective in improving mandibular function in patients with temporo-mandibular disorders who have concurrent temporo-mandibular joint capsulitis and disc displacement without reduction.

J Orofac Pain 1996 Spring;10(2):157-65

Yemi Omilana