Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Most cases of TMJ syndrome are temporary; thus, treatment is usually conservative.
Early therapy starts simply with resting the jaw,
using warm compresses (ice packs at first if an injury is present), and pain
medication. Jaw rest can help heal temporomandibular joints. Eat soft foods.
Avoid chewing gum and eating hard candy or chewy foods. Do not open your mouth
wide. Your doctor may show you how to perform gentle muscle stretching and
relaxation exercises. Stress-reduction techniques may help you manage stress
and relax your jaw along with the rest of your body.
The doctor may fit you with a splint or bite plate.
This is a plastic guard that fits over your upper and lower teeth, much like a
mouth guard in sports. The splint can help reduce clenching and teeth
grinding, especially if worn at night. This will ease muscle tension. The
splint should not cause or increase your pain. If it does, do not use it.
If conservative and noninvasive techniques do not
work, you may consider more invasive techniques.
A more invasive procedure can be performed in the doctor's office or clinic under local anesthesia. This is
carried out by inserting two needles in the temporomandibular joint to wash
it out. One needle is connected to a syringe filled with a cleansing
solution, and the fluid exits via the other syringe. This procedure can be
done in the office. Most people find relief from the pain and return to
almost normal. Sometimes, pain medication can be injected into the joint in
a similar procedure.
Alternatively, a simple injection of cortisone
medication can be very helpful in relieving inflammation and pain.
A last option, surgery, is often irreversible and should be avoided when possible. If necessary, surgery can be used to replace the jaw joints with artificial implants. The National Institute of Dental and Craniofacial Research (NIDCR) advises that if surgery is
recommended, you seek other independent opinions before proceeding.
NIDCR advises that other irreversible treatments are of little value and may not cure the problem. These include orthodontia to change the bite, restorative dentistry, and adjustment of the bite by grinding down teeth to bring the bite into balance.