Your Health

Medications for Temporomandibular Disorders (TMD)

There are no medicines that are specifically designed to treat TMD. However, if you are having a lot of pain and discomfort, your doctor might recommend a pain reliever, muscle relaxant, or a type of antidepressant that is used to treat chronic pain. In severe cases, your doctor or dentist may recommend a shot of a steroid into the joint to decrease inflammation and relieve pain. These medicines are usually used for very brief periods of time. Check with your doctor to determine exactly how long you should be using these types of medicines.

Prescription Medications

Benzodiazepines :

  • Diazepam
  • Alprazolam
  • Clonazepam

Tricyclic antidepressants :

  • Amitriptyline
  • Clomipramine
  • Desipramine
  • Imipramine
  • Nortriptyline (Aventyl, Pamelor)

Over-the-Counter Medications

Acetaminophen

Ibuprofen

Naproxen

Prescription Medications

Benzodiazepines

Common names include:

  • Diazepam
  • Alprazolam
  • Clonazepam

Minor tranquilizers are generally reserved for very severe cases of TMD. These medicines have general and muscle relaxing effects, and they may help relieve some of the pain in your jaw and muscles. They may help you avoid grinding your teeth and/or clenching your jaw while you sleep. The medicines may also relieve anxiety thereby making it easier for you to stop grinding your teeth and/or clenching your jaw during the day.

These medicines are usually prescribed for use at night and for a very brief time, usually less than a month.

Possible side effects include:

  • May be habit-forming if used for a long period of time
  • Daytime drowsiness
  • Dizziness

Do not take these medicines with alcohol or with other medicines that can cause drowsiness, including other sedatives, pain medicines, antihistamines, and sleeping pills.

Tricyclic Antidepressants

Common names include:

  • Amitriptyline
  • Clomipramine
  • Desipramine
  • Imipramine
  • Nortriptyline

Tricyclic antidepressant drugs may be useful for treating chronic pain of severe TMD. These medicines are usually prescribed for use at night and for a very brief time, usually less than a month.

Possible side effects include:

  • Daytime drowsiness
  • Dizziness
  • Dry mouth
  • Weight gain
  • Increased sun sensitivity

Do not take these medicines with alcohol or with other medicines that can cause drowsiness, including other sedatives, pain medicines, antihistamines, and sleeping pills.

Over-the-Counter Medications

Acetaminophen

Common brand names include:

Acetaminophen can be helpful in relieving some of the jaw and muscle pain associated with TMD. It’s also safe to give to children. Do not take a larger dose than is recommended by your doctor. Do not drink alcoholic beverages while you are taking acetaminophen.

Ibuprofen

Common brand names include:

Ibuprofen can also help relieve some of the jaw and muscle pain and inflammation associated with TMD. Because some people find ibuprofen to be very hard on the stomach, you should take this medicine with food. Drinking alcoholic beverages while you are taking ibuprofen can increase the chance that it will irritate your stomach.

On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately call your doctor.

Naproxen

Common brand names include:

Naprosyn is similar to ibuprofen both in action and in side effects.

Special Considerations

Whenever you are taking medication, take the following precautions:

  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Do not share them with anyone else.
  • Know what effects and side effects to expect, and report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you do not run out.

Revision Information

  • Mujakperuo HR, Watson M, et al. Pharmacological interventions for pain in patients with temporomandibular disorders. Cochrane Database Syst Rev . 2010 Oct 6;(10):CD004715.

  • Siccoli MM. Facial pain: a clinical differential diagnosis. Lancet Neurology . 2006;5:257-267.

  • Temporomandibular joint (TMJ) dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 27, 2012. Accessed April 5, 2013.

  • TMJ. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/tmj.cfm . Updated December 2010. Accessed April 5, 2013.

  • TMJ. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/tmj.aspx . Accessed April 5, 2013.

  • TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/TMJ . Updated March 21, 2013. Accessed April 5, 2013.

  • 2/18/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry . 2010;71(10):1259-1272.