What About Antidepressants for TMJ Face Pain?

by | Jul 18, 2013 | TMJ / Pain

painLast month, we looked at some research on the link between depression and face pain. Considering that there are a number of antidpressants that may be given for chronic pain, you might wonder: Why not just take those and proverbially kill the two proverbial birds with a single proverbial stone?

Well, for one, not everyone wants to take pharmaceutical drugs, which are largely designed just to quell undesirable symptoms. Yes, there are times when drugs may bring welcome relief from acute pain, but their help goes little further than this. Long term, drug therapy can create another burden on a body already under physical or mental stress.

That drug therapy is often a “first resort” treatment shouldn’t obscure the fact that there are many gentler, nontoxic and effective alternatives available.

Nor is there much evidence that antidepressants are effective for treating orofacial pain – a fact at the center of a recent paper in Evidence-Based Dentistry.

Its authors looked at 6 previously published single and double blinded randomized trials (RCTs), all of which were found to be top quality. At best, that research was “inconclusive.” There are too few studies, they said, and too many differences among treatments. The authors thus concluded that, as yet, there is “limited evidence to support the effectiveness of antidepressants in orofacial pain disorders.” More RCTs are needed.

The definitive answer on drug therapy for face pain thus remains, “Well, maybe…and only if you want to go that route.”

And if you don’t?

Some forms of “alternative” treatment have shown short-term success – modalities such as acupuncture and coconut oil therapy – but here, too, more research needs to be done.

But is short-term pain-killing really the best approach? In a word, no.

When a patient comes to us complaining of face pain – or other upper body pain commonly associated with TMJ disorders (TMD), we start by looking beyond their pain pattern and history. We consider diet, sleep patterns and how the chewing muscles are working. We look at the big picture. What can we do to help alleviate your pain safely and effectively, without drugs or other short-term solutions that do little more than suppress symptoms?

We strive to help our patients with nontoxic therapies. We may use herbs, nutritional supplements and homeopathics. We may use oral appliances to take pressure off the jaw joints, help the jaw line up in a neutral position or reposition the tongue to sit more forward in the mouth.

And while these don’t address the depression head-on, so to speak, we’ve seen many a patient experience improved mood and mental health as they rigorously and diligently address their physical issues.

Image by Marc Soller, via Flickr

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