Ultrasound to Treat TMJ Disorders? The Evidence Says Yes

Hear the term “ultrasound,” and you likely think of the many ways it’s used in medicine – to monitor the health and development of a child still in the womb, for instance, or examine a breast lump or diagnose certain health problems. It can be used to evaluate blood flow or to guide a biopsy needle.

How are those pictures of a body’s insides even made? A machine called a transducer sends out sound waves that travel through the body until they hit something that reflects them back, such as an organ or bone. When the echoes return to the transducer, it records how long it took. Using the speed of sound, the machine can tell how far away things are inside the body, and that information is what’s used to make pictures of the targeted structures.

It’s pretty cool, really –

Here’s something else you might not know about ultrasound, though: It can be used therapeutically, too. In medicine, it can be used to treat cysts and other abnormal growths, for instance; or remove cataracts; or break up kidney stones or gallstones.

And in dentistry, it can be used to treat TMJ disorders (TMD).

In fact, in our office, ultrasound therapy is often something that Dr. Abdulla recommends along with other therapies in targeting the root causes of an individual’s TMJ troubles, including the sometimes incapacitating pain that can accompany a TMD.

Therapeutic ultrasound works by using oscillations that send deep heat to the chewing muscles that are connected to the jaw joints. The heat increases circulation. The improved circulation, in turn, reduces inflammation and the accompanying pain. Jaw function can be improved, as well.

Consider the case of a 60-year old woman that was published in Physiotherapy Research International a couple years back. It began with a complaint of moderate pain in both jaw joints. Chewing and excessive mouth opening made the pain worse. Opening her mouth would send her baseline pain score of 6 to the maximum pain level of 10.

Her treatment included ultrasound therapy, exercises, TMJ manipulation, and related therapies. Her pain and TMJ function were evaluated every week over the four-week course of care. By the end of it,

There was significant improvement in her mouth opening (41 mm [at baseline, it had been less than 8 mm]), restoration of masticatory [chewing] functions, complete resolution of pain and overall improvement in quality of life….

Randomized, controlled trials have also shown a role for ultrasound therapy in treating TMDs. One 2021 study in the Journal of Pain Research involved 160 TMD patients who were randomly assigned to one of two groups. One group got daily ultrasound therapy, five days each week, over the course of two weeks. The other group received no therapy.

Each patient’s TMJ status was evaluated three times: once at the beginning of the study, four weeks after treatment, and six months after treatment. They were assessed for pain, movement of the lower jaw, jaw noise, and other factors related to TMD.

All of these measures were significantly improved in the treatment group even six months after the therapy had ended. Less than 3% had any recurrence of symptoms by then.

[Ultrasound] therapy can significantly reduce the pain, and improve the functionality of the temporomandibular joint and mouth opening limit for TMD patients, and is therefore recommended for TMD patients.

What could account for the improvement? Previous studies, the authors explain, found that during TMD, inflammatory proteins called cytokines are involved in inflaming the joint lining. This leads to breakdown of the cartilage and excessive death of the cartilage cells in the soft tissue around the bones and joints. It also increases nitric oxide and throws off the normal joint metabolism.

Ultrasound has been shown to counteract this. It appears to promote the growth of cartilage to repair defects and block the release of inflammatory cytokines. In animal models, a special type of low-intensity ultrasound was able to improve jaw growth and change jaw structure. Such modifications of the jaw, the authors suggest, may contribute to ultrasound’s therapeutic effect.

While more research needs to be done to confirm this and further our understanding of the mechanisms involved in improving TMJ health with ultrasound, that it works is something that our patients who have had it could tell you about. Typically, it takes about five sessions to get the kind of lasting improvement described above, as the effects build over time. It’s not a one-and-done therapy.

But it IS a crucial part of the toolkit Dr. Abdulla draws from in helping her patients get enduring relief from even long-lasting TMJ pain and dysfunction.

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