Emergency Department Care

Signs and symptoms of temporomandibular joint (TMJ) disorders improve over time with or without treatment for most patients. As many as 50% of the patients have symptomatic improvement in 1 year and 85% in 3 years. The following conservative measures should be attempted before invasive therapies, such as orthodontics or surgery, are recommended^[12]:

Analgesics - Nonsteroidal anti-inflammatory drugs (NSAIDs) ^[13]
Muscle relaxants - Benzodiazepines
Moist heat and massage of masticatory muscles

A variety of other interventions for TMJ disorders have been proposed, including manual therapy,^{[14, 15]}splints,^{[16, 17]}laser therapy,{ref1726-INVALID REFERENCE} and botulinum toxin injection,^[18]However, evidence supporting the use of these interventions tends to be weak or mixed.

Consultations

Provide outpatient follow-up care with ear, nose, and throat (ENT) specialist or oral surgeon. However, if intractable pain is present, more urgent consultation is necessary.

Medication

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Author

Vivian Tsai, MD, MPH, FACEP Assistant Professor of Emergency Medicine, Mount Sinai School of Medicine, Queens Hospital Center

Vivian Tsai, MD, MPH, FACEP is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Phi Beta Kappa

Disclosure: Nothing to disclose.

Coauthor(s)

Richard H Sinert, DO Professor of Emergency Medicine, Clinical Assistant Professor of Medicine, Research Director, State University of New York College of Medicine; Consulting Staff, Vice-Chair in Charge of Research, Department of Emergency Medicine, Kings County Hospital Center

Richard H Sinert, DO is a member of the following medical societies: American College of Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Steven M Heffer, MD Consulting Staff, Department of Emergency Medicine, Greenwich Hospital

Steven M Heffer, MD is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Gino A Farina, MD, FACEP, FAAEM Professor of Emergency Medicine, Hofstra North Shore-LIJ School of Medicine at Hofstra University; Program Director, Department of Emergency Medicine, Long Island Jewish Medical Center

Gino A Farina, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

Acknowledgements

Jerome FX Naradzay, MD, FACEP Medical Director, Consulting Staff, Department of Emergency Medicine, Maria Parham Hospital; Medical Examiner, Vance County, North Carolina

Jerome FX Naradzay, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Joshua Parnes, MD Resident Physician, Department of Emergency Medicine, Kings County Hospital Center

Disclosure: Nothing to disclose.