This handout is for temporomandibular disorders (dc/tmd axis-i/ii — conservative-first; against irreversible occlusal therapy). Your care team identified this based on: chronic jaw / preauricular / temple / temporal pain ± tmj click / crepitus / limited opening — tmd entry per dc/tmd axis-i (schiffman j oral facial pain headache pmid 24482784).
Other reasons your team may use this plan: tmj clicking / popping / crepitus / locking / catching during jaw movement — disc derangement / djd entry (schiffman pmid 24482784); decreased maximum mouth opening (<40 mm), deviation or deflection on opening — functional-limitation entry; dc/tmd axis-i disc displacement with limited opening or djd; jaw pain with red-flag features (age ≥50 + claudication on chewing + headache + esr/crp for gca, exertional cardiac, unilateral persistent + neck mass) — recognise and route out.
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| patient_education_jaw_rest_soft_diet_no_gum_no_clenching_no_wide_yawn | — | — | — | DC/TMD axis-II + AAOP 2024 commentary aligned — patient education on natural history + self-management is the foundation; reduces fear-avoidance and parafunctional drivers |
| local_heat_or_cold_application_jaw_muscles | — | — | — | Local heat (myalgia) or cold (acute inflammatory flare) — low-cost, low-risk, integrated into self-management |
| gentle_jaw_range_of_motion_and_postural_exercises_home_program | — | — | — | Home jaw ROM + postural exercises — supports the supervised PT in Step 2; Yao BMJ 2023 NMA (PMID 38101924) showed even usual care (home exercise + self-stretch + reassurance) achieved RD 23-30% for MID pain relief |
| ibuprofen (OTC NSAID) | 400 mg | PO | q6-8h PRN, short course | First-line OTC analgesia for myalgia / arthralgia; counsel GI / renal risk; limit to short courses; avoid late pregnancy |
| naproxen (OTC NSAID alternative) | 500 mg | PO | BID PRN, short course | Alternative NSAID; same safety counselling as ibuprofen |
| acetaminophen | 500-1000 mg | PO | q4-6h PRN | Acetaminophen as NSAID-sparing analgesic; safer in CKD / PUD / 3rd-trimester pregnancy; counsel hepatic dosing limits |
Plan: Temporomandibular disorders — conservative-first ladder; AGAINST irreversible occlusal therapy
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Longitudinal chronic-disease arc — 6-12-monthly stable; sooner for flare or worsening. Avoid scope creep into irreversible procedures (occlusal adjustment, orthognathic, total joint replacement) — counsel patient that AAOP 2024 commentary aligned is AGAINST these for routine TMD. Re-screen for axis-II distress at every visit. Maintain self-management foundation indefinitely.
Guideline: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) — Schiffman et al, J Oral Facial Pain Headache 2014 (PMID 24482784) for axis-I + axis-II diagnostic criteria. AAOP 2024 commentary aligned (American Academy of Orofacial Pain). Network meta-analysis of TMD interventions — Yao et al, BMJ 2023 (PMID 38101924). Stabilisation-splint Cochrane — Al-Ani et al, Cochrane Database 2004 (PMID 14973990). All PMIDs live-PubMed-verified 2026-05-26.