Should I See a Doctor or Dentist for TMJ?

If my throat is sore, I call a doctor. If I have a toothache, I call the dentist. What about temporomandibular joint disorder? TMJ disorder seems to straddle the line between medical and dental health. Should I see a doctor or dentist for TMJ disorder?

It can be difficult to decide where to turn for treatment advice. TMJ disorder is often triggered by teeth grinding and jaw clenching (also known as bruxism) and can cause a lengthy list of painful symptoms. Sufferers frequently find themselves dealing with jaw joints that click or lock, sore jaw muscles, facial pain, and overworked facial muscles. Ear pain, tinnitus, neck pain, and even migraines are common as well. Seeking prompt treatment is essential if you want to prevent additional damage and relieve symptoms. Exploring what different healthcare professionals bring to the table allows you to make informed decisions about your healthcare team.

Should I see a Doctor or Dentist for TMJ Disorder?

Ideally, if you suspect TMJ disorder, your first visit should be with your dentist. As TMJ Plus Wellness Center points out, dentists don't just deal with teeth. They're specialists whose training includes a thorough understanding of the jaw's anatomy. This includes the TMJs and how to diagnose and treat dysfunction in the bite. A dentist is also prepared to identify and treat bruxism and bite misalignment. Plus, they have the tools and training needed to treat the dental damage that unchecked teeth grinding and jaw clenching can cause. Dentists generally know how to treat TMJ, so they're normally a great place to start your treatment journey. However, some dentists may not be as well informed about TMJ treatments as others. They may refer you to a doctor or a TMJ specialist for a more involved treatment plan.

If you feel more comfortable approaching your primary care doctor first, that’s okay as well. A general practitioner will still be able to offer some guidance. While most won't have a dentist's specialized knowledge of the jaw, they should be able to confirm the diagnosis and offer some insight about next steps or even possible treatments. Many will refer you to a dentist or TMJ disorder specialist.

Both dentists and doctors can ask questions about your TMJ disorder symptoms. Both can examine your teeth and jaw for signs of damage. Both can order X-rays or other imaging tests. The type of doctor that can provide the most help may largely depend on how severe your case is, which side effects you suffer from, and the underlying cause of your TMJ. Visiting a professional can lay the groundwork for a diagnosis and help you get the proper treatment for your condition.

Can Both Doctors and Dentists Prescribe Treatments for TMJ Disorders?

While both doctors and dentists can prescribe some of the treatment options for TMJ disorders, the treatments that they offer vary. Therefore, the type of treatment that you need will determine the type of healthcare professional you visit. Common treatments include splint therapy, medications, and botox injections.

Mouthguards and Oral Splints

Mouthguards are commonly referred to as night guards, occlusal splints, or stabilization splints, but these oral appliances all share the same purpose. A mouthguard or splint sits between the teeth of the upper jaw and the lower jaw to establish a barrier and prevent teeth grinding. You can purchase custom-fit night guards for bruxism online. However, TMJ disorder is more complex, so these devices require a professional touch. As MedicineNet explains, the mouthguards for TMJ disorder are usually prescribed and fitted by a jaw specialist like a dentist or TMJ specialist. In fact, these appliances may require adjustment as treatment progresses.

Medications

TMJ disorder can cause pain in the jaw, face, ear, neck, and back. It's also associated with migraines and headaches. While some people find relief quickly, other unlucky individuals deal with chronic pain. Dentists and doctors can prescribe several different medications to help patients deal with TMJ disorder. These include pain medications, anti-inflammatory medications, muscle relaxants, and corticosteroids. Over-the-counter medications such as ibuprofen can help manage pain as well.

Botox

Botulinum toxin (or botox) injections are used for many purposes such as wrinkle prevention and reducing sweat. Botox can also be used to temporarily weaken the jaw muscles on the sides of your face, disabling them from overworking and becoming sore. This gives the muscles a chance to rest and for related jaw pain and discomfort to subside.

Lifestyle Changes

Avoid things that will irritate the TMJs. Eat soft foods when possible and avoid chewy foods or chewing gum. Additionally, some vitamin deficiencies can lead to teeth grinding and TMJ. Make sure your diet includes sufficient amounts of calcium, Vitamin B, magnesium, etc.

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Are There Other Healthcare Professionals Who Can Help With TMJ Pain?

It's comforting to know where you can turn for help. Mayo Clinic offers suggestions for other healthcare professionals who can help with TMJ pain:

• Surgeons for TMJ: TMJ disorder surgery is normally reserved as a last resort. However, if more conservative treatments fail, it may be necessary for the most severe cases of TMD. Various procedures are possible. With a TMJ arthroscopy (or arthrocentesis), the surgery is performed through a tiny tube to minimize the intrusion and risk. At the opposite end of the spectrum, open-joint surgery allows for bigger repairs but creates greater strains and dangers.
• Physical therapists for TMJ: Physical therapy can include customized programs to strengthen and stretch jaw muscles. Ultrasound, moist heat, and ice to reduce inflammation may also be included.
• Botox specialists: Botox injections into the chewing muscles temporarily weakens them. This reduces grinding and clenching.
• Acupuncturists: Acupuncture is a form of traditional Chinese medicine that's been used to treat chronic pain for hundreds of years. It involves the targeted placement of thin needles into pressure points, causing relaxation of tense muscles.
• Orthodontists: If your TMJ is related to orthodontic treatments, your ortho might have suggestions on treatments for your specific case. They can also make recommendations for bite misalignments.

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Doctor or Dentist for TMJ

If you're experiencing symptoms of TMJ disorder, the important thing is to seek treatment promptly to address symptoms before they progress. You can approach either your doctor or your dentist first. Thanks to their familiarity with the jaw, your dentist will likely have a greater understanding of TMJ disorder, so you may be better off starting there. However, if you're more comfortable talking to your primary care doctor or want to eliminate some other possibilities, there's certainly nothing wrong with beginning your treatment journey there. When wellness is the goal, having your healthcare team on the same page is vital. Understanding what each member can offer helps you get the best treatment.

References:

• Cunha, J. P. (2021). 14 best TMJ treatments, symptoms, pain relief, surgery, causes, remedies. MedicineNet. https://www.medicinenet.com/temporomandibular_joint_syndrome_tmj/article.htm
• Mayo Clinic Writing Staff. (2018). TMJ disorders. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/tmj/diagnosis-treatment/drc-20350945
• TMJ Plus Wellness Center Writer. (2020). What kind of doctor do I see for TMJ pain? TMJ Plus Wellness Center. https://www.tmjplus.com/what-kind-of-doctor-do-i-see-for-tmj-pain/