TMJD Medications: From NSAIDs to Anticonvulsants

When an issue develops in the joint that allows your mouth to open and close, it can be painful. Most of the time, though, it responds well to conservative treatment and TMJD medications.

You have two temporomandibular joints (TMJs). They are located on opposite sides of your head, directly in front of your ears. They’re the joints that allow your jaw to hinge open and shut.

When this area becomes painful, stops functioning correctly, or starts making unusual noises, you may be experiencing temporomandibular joint dysfunction, formally known as temporomandibular joint disorder (TMJD, also sometimes referred to as TMD or TJD).

There are many different causes of TMJDs. Joint friction, bone changes, arthritis, and muscle weakness can all be underlying factors.

While lifestyle changes and other conservative approaches make a difference for most people, you may find additional symptom relief through TMJD medications.

There’s no magic pill that works for all types of TMJDs. In fact, there’s no medication specifically approved by the Food and Drug Administration (FDA) for TMJD treatment.

About half of all denied claims that are challenged or appealed ultimately end up being covered – but only when policyholders put in the time and energy to fight the denial, the Los Angeles Times

Research from 2018 indicates that the drugs used for TMJD are selected based on how well they work on other musculoskeletal conditions. Overall, more TMJD-specific studies are needed to truly determine their effectiveness.

A doctor can make a recommendation based on your level of discomfort, present impairment, and the root cause of the TMJD.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are considered first-line TMJD medications for both chronic and acute cases. They’re used to help reduce mild to moderate inflammation and provide pain relief.

Research from 2017 suggests that certain NSAIDs, like ibuprofen and naproxen, have been proven effective for dental pain, which makes them reasonable options for TMJD.

Opioids

Opioids are pain relievers or analgesics. They work by blocking pain channels in the brain and altering brain chemistry. However, because they can lead to dependency and addiction, they’re prescribed only when other pain medications aren’t working well, especially if TMJD is chronic.

Corticosteroids

Corticosteroids have potent anti-inflammatory effects. They’re used to help treat moderate to severe TMJD and can be taken by mouth, applied topically, or delivered into the TMJ by injection.

Common corticosteroids used for TMJD include:

  • methylprednisolone
  • triamcinolone hexacetonide

Muscle relaxants

TMJD isn’t limited to your bone connections. Your muscles around the TMJ may also be overactive. They can spasm or tense, contributing to your discomfort. When this happens, muscle relaxants can help.

Examples of muscle relaxants used for TMJD include:

Antidepressants

While it may sound strange to take an antidepressant for a jaw condition, these medications have been prescribed as TMJD treatments for more than 3 decades, according to the 2017 research mentioned earlier.

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Antidepressants suppress the activity of the central nervous system (CNS). When the CNS is less active, it dampens pain signals and muscle stimulation.

Antidepressants have varying effects when it comes to TMJD. Selective serotonin reuptake inhibitors, for example, are effective for mouth and facial pain, but tricyclic antidepressants appear to be the most effective for TMJD, the 2017 research found.

Examples of antidepressants for TMJD include:

Benzodiazepines

Benzodiazepines are another type of drug that affects the CNS. They’re prescribed to treat many different conditions, including seizures, muscle spasms, anxiety, and insomnia.

In TMJD, they’re sometimes taken to help reduce muscle spasms and teeth grinding.

Anticonvulsants

Anticonvulsants work to decrease neuronal excitement and have been found to help with nerve-related pain. Little evidence supports the use of anticonvulsants for TMJD, however.

Anticonvulsant medications include:

Topicals

Topical medications, like capsaicin cream, may help relieve muscle pain in the jaw the same way they do in other areas of the body. Research is limited, but this 2017 study found that capsaicin cream significantly lowered pain for a week following application.

Take care with using these creams close to your eyes.

Get involved with clinical trials

Despite the fact that TMJD affects as much as 70% of the population, TMJD medications are understudied.

Clinical trials offer a way to explore emerging treatment options, and they’re also a great opportunity to help pave the way for others living with TMJD. Make sure to talk with your doctor before beginning a clinical trial.

You can learn more about TMJD clinical trials by visiting:

  • The TMJ Association
  • ClinicalTrials.gov
  • ResearchMatch

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