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Treating TMD – Plano, TX

How We Can Stop Your Chronic Pain

At Orofacial Pain Associates, we’re happy to offer our patients several ways to make their TMD-related pain stop. This variety of services enables our doctors to finely tailor our treatment plans to suit the particular needs and wants of each patient. Which of the treatments below would help you finally stop experiencing pain? Probably all of them in one way or another, but to determine which ones would be ideally suited to your situation, contact us today to schedule an appointment.

Appliance Therapy

We can provide a patient with a custom-made mouthguard that will slightly reposition their jaw while they sleep. This serves two purposes. One, it can remove any excess pressure or strain being placed on the muscles and nerves of the TMJ, and two, it can prevent bruxism, or nighttime teeth grinding. Bruxism is a very common cause of TMD, and it can make the condition progressively worse if not addressed directly. After using the appliance every night for a few months, a patient should be able to go throughout their day without experiencing any pain.


Pharmacotherapy is a fancy term that basically means “treating the problem using medication.” This is typically the best approach for patients dealing with neurovascular headaches, connective tissue disorders, and chronic pain that needs to be managed over a long period of time. It can also help with sleep regulation, as TMD can be both a result and a cause of frequent sleep disturbances, sometimes leading to the development of sleep apnea.

Physical Therapy

Daily stress can often lead to unconscious jaw clenching throughout the day that tires out the muscles and makes them sore. With physical therapy, we can help a patient become aware of when they are clenching, show them how to relax the muscles throughout the day, and teach exercises that can help prevent clenching in the future. Massage, therapeutic ultrasound, and hot/cold therapy can also aid in this process.


Stress, anxiety, and depression can all lead to the development of a TMD, and without addressing these directly, the physical pain will never fully go away. In addition to treating a patient’s body, we can provide relaxation therapy, stress management, and resources to deal with anxiety/depression so that the root cause of the TMD can be managed and drastically reduced, leading to the abatement of pain.

Injection Procedures

A variety of injection treatments can be used to provide both short and long-term relief for patients dealing with TMD. We can inject fluid into the joint to help us diagnose the condition in the first place, and then nerve blocks or steroids to quickly stop any pain. To the surprise of many, Botox is also a very effective TMD treatment. It can calm and relax overactive jaw muscles that lead to nighttime teeth grinding and create face/head pain.

Trigger Point Injections or Botox?

In short, trigger point injections can be amazingly effective for muscle pain or headaches; they simply are not extensively advertised, compared to Botox.

Sometimes Botox injections may be unnecessary or possibly over-treatment, but everyone has heard about Botox. A trigger point injection consists of an anesthetic combined with steroid. Dr. Spencer will take time to precisely locate painful knots in your facial, neck or shoulder muscles. Precise placement can often relieve pain immediately.

The key advantages of trigger point injections are cost and speed of relief. These injections are significantly less expensive than Botox and can often provide relief in a matter of minutes. Trigger point injections have proven safe and effective with over 60 years of widespread clinical use.

Botox is botulinum toxin which is injected judiciously into musculature. Botox works by paralyzing muscle contraction for several weeks. It can be effective in relief of pain and headaches but is not necessarily the first choice. Botox will typically outlast a trigger point injection but may take a week or two to reach peak effectiveness.

Either trigger point injection or Botox injection works best when combined with other modalities such as massage, physical therapy, or muscle relaxants.

Talk with Dr Spencer to decide which approach might be best for your pain.

Coordinate Multidisciplinary Protocol

Sometimes, adequately treating a patient’s TMD requires a team of doctors, ranging from orthodontists to neurologists to sleep doctors and more. The team at Orofacial Pain Associates is happy to coordinate with other physicians to ensure a patient receives the highest level of care. Whether we are the first doctor or the 50th you have come to see about your pain, we’ll make sure everyone is on the same page and is working together to provide the answers you need.

Patient Education

In addition to treating patients, we also seek to empower them by providing knowledge and skills they can use to manage, reduce, and stop their TMD-related pain. This can involve helping a patient better understand what is causing their pain, how they can modify their behavior to improve it, and what daily practices they can implement to achieve long-term relief. With this approach, we’re able to help patients even when they aren’t physically sitting in our office!