Treatments for Temporomandibular Joint Disorders (TMD) in Children

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At Boston Children's, we consider you and your child integral parts of the care team. You and your care team—which can include pediatric dentists, otolaryngologists (ear, nose and throat doctors) and oral surgeons—will work together to customize a plan of care for your child. 

What makes Boston Children's different?

Physicians and researchers in Children's Oral and Maxillofacial Surgery Program combine a tradition of surgical excellence with innovative research. Our multidisciplinary team works in conjunction with dentists and physical therapists to treat children with TMD. 

How is TMD treated?

There is a range of options for how your child's doctor may choose to treat his TMD based on how severe his symptoms are. For many children, self care will be enough to manage TMD; for others, physical therapy, dental treatments and joint surgery may be needed. 

Self-care

Many minor TMJ problems can often be cared for at home with no other treatment needed. Here are some tips that may reduce the discomfort from TMD: 

  • Have your child rest the jaw joint when it becomes tender.
  • Avoid hard or chewy food that can strain muscles of the face.
  • Use moist heat to help relax muscles of the face.
  • Teach your child to perform range-of-motion jaw exercises.
  • Monitor your child's stress and anxiety levels.
  • Ask your child's dentist to evaluate him for grinding or clenching of teeth. 

Medications

Your child's surgeon may prescribe anti-inflammatory medications and/or muscle relaxants to help alleviate jaw pain and encourage easier jaw movement. 

Physical therapy

If home care isn't enough, a physical therapist can help your child with stretching and strengthening,. There are a variety of possible treatments, including: 

  • Jaw exercises
  • Posture training
  • Electrical stimulation: low-level electrical currents can help relax your child's jaw joint and facial muscles
  • Ultrasound: deep heat can be applied to a sore or immobile joint
  • Biofeedback: a type of relaxation therapy that uses electronic instruments to give your child immediate feedback about what effect the relaxation exercises are having on his jaw joint and facial muscles 

Dental treatment/splint therapy

If your child is clenching or grinding his or her teeth, his doctor may suggest that a dentist make a night guard or splint to protect your child's teeth and jaw. 

Surgery

If your child needs surgery, physicians in our Oral and Maxillofacial Surgery Program can help her get better, faster. Here are the different kinds of surgery used to treat severe TMD:

  • Arthrocentesis — This is a procedure where two needles are inserted into the temporomandibular joint space. The surgeon then injects sterile fluid to clean the joints.
    • Medications to lubricate the joint may be added at the end of the procedure to help reduce inflammation or pain.
       
  • Arthroscopy — An endoscope (a small flexible tube with a camera attached to it) is inserted into the joint in order to see where the problems are. The endoscope may be used to remove cartilage fragments and scar tissue.
     
  • Open joint surgery — In this surgery, the surgeon makes an incision and then removes, reshapes or repositions parts of the joint to reduce pain and improve its function.
     
  • Joint replacement — If your child's TMJ is so damaged that it needs to be replaced, the surgeon can reconstruct the joint.
     
  • Orthognathic (jaw) surgery If your child's pain is a result of misalignment of the jaw (malocclusion), the doctor may recommend jaw surgery to correct the problem.


Coping and support 

On our For Patients and Families site, you can read all you need to know about: 

  • Getting to Children's
  • Accommodations
  • Navigating the hospital experience
  • Resources that are available for your family 

Outside resources:

  • The American Association of Oral and Maxillofacial Surgeons offers an informative page about the TMJ.

 


 

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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