Medications for Temporomandibular Disorders (TMD)
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There are no medications that are specifically designed to treat TMD. However, if you are having a lot of pain and discomfort, your doctor might recommend a prescription or an over-the-counter pain reliever, muscle relaxant, or antidepressant (a type that is used to treat chronic pain). In severe cases, your doctor or dentist may recommend a shot of a steroid into the joint to decrease inflammation and relieve pain. These medicines are usually used for very brief periods of time. Check with your doctor to determine exactly how long you should be using these types of medicines.
Prescription Medications
- Diazepam (Diastat, Diazepam Intensol, Dizac, Valium)
- Alprazolam (Alprazolam Intensol, Xanax)
- Amitriptyline (Elavil, Endep)
- Clomipramine (Anafranil)
- Desipramine (Norpramin)
- Imipramine (Norfranil, Tipramine, Tofranil)
- Nortriptyline (Aventyl, Pamelor)
Over-the-Counter Medications
- Tylenol
- Advil
- Excedrin IB
- Motrin
- Nuprin
- Aleve
- Naprosyn
Prescription Medications
Minor Tranquilizers
Common names include:
- Diazepam (Valium)
- Alprazolam (Xanax)
Minor tranquilizers are generally reserved for very severe cases of TMD . These medications have general and muscle relaxing effects, and they may help relieve some of the pain in your jaw and muscles. They may help you avoid grinding your teeth and/or clenching your jaw while you sleep. The medications may also relieve anxiety , thereby making it easier for you to stop grinding your teeth and/or clenching your jaw during the day.
These medicines are usually prescribed for use at night and for a very brief time (usually less than a month).
Possible side effects include:
- May be habit-forming if used for a long period of time
- Daytime drowsiness
- Dizziness
Don’t take these medicines with alcohol or with other medicines that can cause drowsiness, including other sedatives, pain medications, antihistamines, and sleeping pills.
Tricyclic Antidepressants
Common names include:
- Amitriptyline (Elavil, Endep)
- Clomipramine (Anafranil)
- Desipramine (Norpramin)
- Imipramine (Norfranil, Tipramine, Tofranil)
- Nortriptyline (Aventyl, Pamelor)
Tricyclic antidepressant drugs have been found to be effective for treating chronic pain of severe TMD. These medicines are usually prescribed for use at night and for a very brief time (usually less than a month).
Possible side effects include:
- Daytime drowsiness
- Dizziness
- Dry mouth
- Increased sun sensitivity
Don’t take these medicines with alcohol or with other medicines that can cause drowsiness, including other sedatives, pain medications, antihistamines, and sleeping pills.
Over-the-Counter Medications
Acetaminophen
Common brand names include:
- Actamin
- Banesin
- Tylenol
Acetaminophen can be helpful in relieving some of the jaw and muscle pain associated with TMD. It’s also safe to give to children. Do not take a larger dose than is recommended by your doctor. Do not drink alcoholic beverages while you are taking acetaminophen.
Ibuprofen
Common brand names include:
- Advil
- Excedrin IB
- Motrin
- Nuprin
Ibuprofen can also help relieve some of the jaw and muscle pain and inflammation associated with TMD. Because some people find ibuprofen to be very hard on the stomach, you should take this medicine with food. Drinking alcoholic beverages while you are taking ibuprofen can increase the chance that it will irritate your stomach.
On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately call your doctor.
Naproxen
Common brand names include:
- Aleve
- Naprosyn
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
- Take them as directed—not more, not less, not at a different time.
- Do not stop taking them without consulting your doctor.
- Don’t share them with anyone else.
- Know what effects and side effects to expect, and report them to your doctor.
- If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
- Plan ahead for refills so you don’t run out.
References:
Cummings CW. Otolaryngology: Head & Neck Surgery . 4th ed. St. Louis, MO: Mosby; 2005.
Dambro MR. Griffith’s 5-Minute Clinical Consult . Philadelphia, PA: Lippincott Williams & Wilkins; 2006.
Okeson, Jeffrey. Clinical Management of Temporomandibular Disorders and Occlusion. 6th ed. St. Louis, MO: Mosby 2007.
Siccoli MM. Facial pain: a clinical differential diagnosis. Lancet Neurology . 2006; 5:257-267.
TMD/TMJ (temporomandibular disorders). American Dental Association website. Available at: http://www.ada.org/public/topics/tmd_tmj.asp . Accessed September 17, 2008.
TMJ. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/tmj.cfm . Accessed September 17, 2008.
TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/TMJ/ . Updated August 2008. Accessed September 17, 2008.
Last reviewed June 2008 by Laura Morris-Olson, DMD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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