Treatments for Temporomandibular Joint Dysfunction (TMJ) in Children

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Contact the Department of Plastic and Oral Surgery

  • 1-617-355-7252

If your child has been diagnosed with temporomandibular disorder (TMD), you may be confused and overwhelmed. But you can rest assured that, at Boston Children's Hospital, your child is in good hands.
 
At Children's, we consider you and your child integral parts of the care team and not simply recipients of care. 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 Hospital 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.

My child is in pain. What can we do?

If your child is suffering from TMJ pain, there are several things you can do to help prevent it worsening:

  • Rest the jaw when it becomes tender.
  • Avoid hard or chewy foods that can strain muscles.
  • Use moist heat to help relax the surrounding muscles.
  • Monitor your child's stress and anxiety levels.
  • Ask your dentist to evaluate your child for grinding or clenching of teeth.

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, however, 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 face muscles.
  • Use moist heat to help relax your child's facial muscles.
  • 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 oral and maxillofacial 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, which can reduce pain. 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 nightguard or splint to protect your child's teeth and jaw.

Surgery

Most children with TMD will not require surgery. However, if your child needs surgery, physicians in our Oral and Maxillofacial Surgery Program can help your child get better, faster. Here are the different kinds of surgery used to treat severe TMD.

  • Arthrocentesis — This is a minimally invasive procedure where two needles are inserted through the skin into the temporomandibular joint space. The surgeon then injects sterile fluid to break up adhesions and 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 using autogenous or synthetic materials.
     
  • Orthognathic (jaw) surgery –If your child's pain is a result of malocclusion (misalignment of the jaw), the doctor may recommend jaw surgery to correct the problem.

Prevention

If your child is suffering from TMJ pain, there are several things you can do to help prevent it worsening:

  • Rest the jaw joint when it becomes tender.
  • Avoid hard or chewy foods that can strain face muscles.
  • Use moist heat to help relaxation the surrounding muscles.
  • Monitor your child's stress and anxiety levels.
  • Have a dentist evaluate your child for grinding or clenching of teeth.

If the pain persists, your doctor may recommend dental or surgical treatment.


Coping and support

It is essential to remember that while hearing that your child is diagnosed with TMD can feel isolating, many children and their families have been down this path before. We have helped them, and we can help you, too.

There are lots of resources available for your family—within Children's, in the outside community and online.

Children's resources for families:

Patient education:From the very first visit, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have. And they'll also reach out to you by phone, continuing the care and support you received while at Children's.

Parent to parent: Want to talk with someone whose child has been treated for TMD? We can put you in touch with other families who have been through similar experiences and can share their experience.

Faith-based support:If you are in need of spiritual support while in the hospital, we'll help connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions who will listen to you, pray with you and help you observe your own faith practices during this difficult time.

Social work and mental health professionals: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.

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 offer 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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