November marks TMJ Awareness Month, a timely reminder of how common jaw pain and dysfunction are among patients. To support informed clinical conversations, oral and maxillofacial surgeon Dr. Justin Richer of Riverside Oral Surgery has compiled an expert guide outlining key considerations in TMJ assessment and management. His insights highlight current treatment approaches, red-flag symptoms, and when referral or early intervention is warranted.
Dr. Richer's guide to all things TMJ
1. Botox for TMJ ... help or hype?
A lot of people call us thinking Botox is the treatment for TMJ. In reality, most TMJ problems start in the joint, and the muscles are reacting to that. Botox can help with muscle soreness, but it doesn’t fix the source. I’ll use it to augment TMJ therapy, but it’s not my first-line treatment and it’s not a cure. While patients may feel temporary relief, the effects diminish over time turning a temporary Band-Aid into a recurring dependency rather than a long-term solution.
2. What are your thoughts on mouth tape?
Lack of sleep and stress are definitely linked to bruxism/clenching. There is no true research though that confirms that mouth taping will clinically resolve the clenching or fix your pain.
3. The bite and joint connection
TMJ and the bite are connected systems. The jaw joint has teeth at the end of it. If someone is missing teeth, has posterior breakdown, lots of crowns/root canals on back teeth, or an uneven bite, that can change chewing dynamics and put more strain on the joint. Sometimes the joint problem causes the bite problems and sometimes it is the other way around.
4. At-home red flags and early intervention
If there’s clicking, popping, or pain when you open or close your mouth, that’s the jaw’s version of a check-engine light. The earlier it’s evaluated, the better the outcome. TMJ is one of those conditions that can quietly progress if ignored. While there’s no quick at-home fix, he emphasizes evaluation, early referral, and conservative management like appliance therapy to prevent long-term damage.
5. New, minimally invasive TMJ treatments
Between night guards (occlusal appliances) and full open-joint surgery, there’s now a growing group of minimally invasive TMJ procedures. We can flush the joint (arthrocentesis) to remove inflammation, inject PRP or hyaluronic acid, or even use a small scope to visualize and treat directly. These are low-downtime options that can really help the right patient.
TMJ disorders require careful evaluation and a tailored, stepwise approach to care. Dr. Richer’s guide offers practical information to help clinicians navigate patient concerns, differentiate muscle-related symptoms from joint pathology, and identify appropriate next steps, from conservative therapies to minimally invasive treatment options. With TMJ disorders in the spotlight this month, now is a great time to reinforce best practices and help patients better understand their path to relief.
Editor's note: This article originally appeared in The Bottom Line with Dental Economics, the newsletter that will elevate your inbox with practical and innovative practice management and clinical content from experts across the field. Subscribe here.
