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Uses

  • Temporomandibular Joint Syndrome
  • TMD
  • TMJ
  • TMJ Syndrome

Temporomandibular disorder (TMD) is a painful problem of the joint in the jaw. These are the small joints in front of each ear. They attach the lower jaw to the skull. TMD may be in the joint in the jaw or the muscles around it.

It is treated with lifestyle changes, medicine, and physical therapy. Some people may need surgery. Others may turn to natural therapies to further ease symptoms.

Natural Therapies

Likely Effective

These therapies are likely to help:

  • Cognitive behavioral therapy M1, M2
  • Myofascial therapy N1

May Be Effective

These therapies may be effective:

  • Acupuncture uses thin needles or lasers in specific body parts to ease symptoms. C1-C9
  • Biofeedback is a method used to help control some body functions using electronical sensors. A1-A3
  • Dry needling a needle that does not contain medication to ease pain. I1, I2
  • Hypnotherapy uses hypnosis to ease pain. B1-B2
  • Manipulative multi-modal therapy O1
  • Manual therapy is the use of a health care worker's hands to ease soft tissue pain. L1-L3
  • Physical therapy is the use of exercises and other therapies to help ease pain and restore function. J1
  • Prolotherapy uses injections in the muscles to ease pain. D1-D6
  • Psychosocial interventions P1

Herbs or supplements that may be effective are:

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions. Be cautious when using TCHM. Herb mixtures and the amounts used vary, and can be toxic.

References

Biofeedback

REFA1 Crider AB, Glaros AG. A meta-analysis of EMG biofeedback treatment of temporomandibular disorders. J Orofac Pain. 1999;13(1):29-37.

REFA2 Shedden Mora MC, Weber D, et al. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain. 2013;29(12):1057-1065.

REFA3 Sato M, Iizuka T, et al. Electromyogram biofeedback training for daytime clenching and its effect on sleep bruxism. J Oral Rehabil. 2015;42(2):83-89.

Hypnotherapy

REFB1 Abrahamsen R, Baad-Hansen L, et al. Effect of hypnosis on pain and blink reflexes in patients with painful temporomandibular disorders. Clin J Pain. 2011;27(4):344-351.

REFB2 Zhang Y, Montoya L, et al. Hypnosis/Relaxation therapy for temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. J Oral Facial Pain Headache. 2015;29(2):115-125.

Acupuncture

REFC1 Jung A, Shin BC, et al. Acupuncture for treating temporomandibular joint disorders: a systematic review and meta-analysis of randomized, sham-controlled trials. J Dent. 2011;39(5):341-350.

REFC2 Ferreira LA, de Oliveira RG, et al. Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers Med Sci. 2013;28(6):1549-1558.

REFC3 Huang YF, Lin JC, et al. Clinical effectiveness of laser acupuncture in the treatment of temporomandibular joint disorder. J Formos Med Assoc. 2014;113(8):535-539.

REFC4 Hu WL, Chang CH, et al. Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders. PLoS One. 2014;9(10):e110528.

REFC5 Fernandes AC, Duarte Moura DM, et al. Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. J Oral Facial Pain Headache. 2017 Summer;31(3):225-232.

REFC6 Wu JY, Zhang C, et al. Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders: A PRISMA-compliant meta-analysis. Medicine (Baltimore). 2017 Mar;96(9):e6064.

REFC7 La Touche R, Goddard G, et al. Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain. 2010 Jul-Aug;26(6):541-550.

REFC8 List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010 May;37(6):430-451.

REFC9 Cho SH, Whang WW. Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain. 2010 Spring;24(2):152-162.

Prolotherapy

REFD1 Refai H, Altahhan O, et al. The efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: a preliminary prospective, randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg. 2011;69(12):2962-2970.

REFD2 Zhou H, Hu K, et al. Modified dextrose prolotherapy for recurrent temporomandibular joint dislocation. Br J Oral Maxillofac Surg. 2014;52(1):63-66.

REFD3 Cömert Kiliç S, Güngörmüş M. Is dextrose prolotherapy superior to placebo for the treatment of temporomandibular joint hypermobility? A randomized clinical trial. Int J Oral Maxillofac Surg. 2016;45(7):813-819.

REFD4 Majumdar SK, Krishna S, et al. Single injection technique prolotherapy for hypermobility disorders of TMJ using 25%. J Maxillofac Oral Surg. 2017;16(2):226-230.

REFD5 Refai H. Long-term therapeutic effects of dextrose prolotherapy in patients with hypermobility of the temporomandibular joint: a single-arm study with 1-4 years' follow up. Br J Oral Maxillofac Surg. 2017;55(5):465-470.

REFD6 Nagori SA, Jose A, et al. The efficacy of dextrose prolotherapy over placebo for temporomandibular joint hypermobility: A systematic review and meta-analysis. J Oral Rehabil. 2018 Dec;45(12):998-1006.

Glucosamine

REFE1 Cahlin BJ, Dahlström L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(6):760-766.

REFE2 Haghighat A, Behnia A, et al. Evaluation of glucosamine sulfate and Ibuprofen effects in patients with temporomandibular joint osteoarthritis symptom. J Res Pharm Pract. 2013;2(1):34-39.

REFE3 Damlar I, Esen E, et al. Effects of glucosamine-chondroitin combination on synovial fluid IL-1β, IL-6, TNF-α and PGE2 levels in internal derangements of temporomandibular joint. Med Oral Patol Oral Cir Bucal. 2015;20(3):e278-e283.

REFE4 Cen X, Liu Y, et al. Glucosamine oral administration as an adjunct to hyaluronic acid injection in treating temporomandibular joint osteoarthritis. Oral Dis. 2018;24(3):404-411.

REFE5 Melo G, Casett E, et al. Effects of glucosamine supplements on painful temporomandibular joint osteoarthritis: A systematic review. J Oral Rehabil. 2018;45(5):414-422.

Traditional Chinese Herbal Medicine

REFF1 Ritenbaugh C, Hammerschlag R, et al. Comparative effectiveness of traditional Chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain. J Pain. 2012;13(11):1075-1089.

Capsaicin Cream

REFG1 Winocur E, Gavish A, Halachmi M, Eli I, Gazit E. Topical application of capsaicin for the treatment of localized pain in the temporomandibular joint area. J Orofac Pain. 2000;14(1):31-36.

REFG2 Campbell BK, Fillingim RB, Lee S, Brao R, Price DD, Neubert JK. Effects of high-dose capsaicin on TMD subjects: a randomized clinical study. JDR Clin Trans Res. 2017;2(1):58-65.

Other Therapies

REFH1 Christidis N, Lindström Ndanshau E, et al. Prevalence and treatment strategies regarding temporomandibular disorders in children and adolescents-A systematic review. J Oral Rehabil. 2019 Mar;46(3):291-301.

Dry Needling

REFI1 Vier C, Almeida MB, et al. The effectiveness of dry needling for patients with orofacial pain associated with temporomandibular dysfunction: a systematic review and meta-analysis. Braz J Phys Ther. 2019 Jan - Feb;23(1):3-11.

REFI2 Machado E, Machado P, et al. A systematic review of different substance injection and dry needling for treatment of temporomandibular myofascial pain. Int J Oral Maxillofac Surg. 2018 Nov;47(11):1420-1432.

Physical Therapy

REFJ1 Amorim CSM, Espirito Santo AS, et al. Effect of Physical Therapy in Bruxism Treatment: A Systematic Review. J Manipulative Physiol Ther. 2018 Jun;41(5):389-404.

Exercise

REFK1 Armijo-Olivo S, Pitance L, et al. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther. 2016 Jan;96(1):9-25. K2. List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010 May;37(6):430-451.

Manual Therapy

REFL1 Armijo-Olivo S, Pitance L, et al. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther. 2016 Jan;96(1):9-25.

REFL2 Martins WR, Blasczyk JC, et al. Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis. Man Ther. 2016 Feb;21:10-17.

REFL3 Calixtre LB, Moreira RF, et al. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil. 2015 Nov;42(11):847-861.

Cognitive Behavioral Therapy

REFM1 Randhawa K, Bohay R, et al. The Effectiveness of Noninvasive Interventions for Temporomandibular Disorders: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Clin J Pain. 2016 Mar;32(3):260-278.

REFM2 List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010 May;37(6):430-451.

Myofascial Therapy

REFN1 Randhawa K, Bohay R, et al. The Effectiveness of Noninvasive Interventions for Temporomandibular Disorders: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Clin J Pain. 2016 Mar;32(3):260-278.

Manipulative and Multimodal Therapy

REFO1 Brantingham JW, Cassa TK, et al. Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review. J Manipulative Physiol Ther. 2013 Mar-Apr;36(3):143-201.

Psychosocial Interventions

REFP1 Aggarwal VR, Lovell K, et al. Psychosocial interventions for the management of chronic orofacial pain. Cochrane Database Syst Rev. 2011 Nov 9;(11):CD008456.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 12/2019
  • Update Date: 06/24/2020