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382 Temporomandibular disorders
n Summary and recommendations
First line: NSAID (e.g. ibuprofen 400–600 mg PO QID; naproxen 500 mg
PO BID)
Reasonable:
n amitriptyline 10–25 mg PO qHS
n clonazepam 10 mg PO qHS or diazepam 2.5–5 mg PO qHS
Pregnancy:
n acetaminophen (650–1000 mg PO QID)
n opioids (e.g. oxycodone 5–10 mg PO q4–6h)
Pediatric: ibuprofen (10 mg/kg PO QID)
Special cases:
n TMD caused by anxiety: clonazepam 10 mg PO qHS or diazepam 2.5–5mg
PO qHS
n nighttime bruxism: amitriptyline 10–25 mg PO qHS or clonazepam 10 mg
PO qHS or diazepam 2.5–5 mg PO qHS
n chronic TMD: diazepam 2.5–5 mg PO qHS
References
1. National Institutes of Health. Technology Assessment Conference on Management
of Temporomandibular Disorders. Bethesda, MD: National Institutes of Health,
1996.
2. List T, Axelsson S, Leijon G. Pharmacologic interventions in the treatment of
temporomandibular disorders, atypical facial pain, and burning mouth syndrome.
A qualitative systematic review. J Orofac Pain. 2003;17(4):301–310.
3. Dionne RA. Pharmacologic treatments for temporomandibular disorders. Oral
Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83(1):134–142.
4. Singer E, Dionne R. A controlled evaluation of ibuprofen and diazepam for
chronic orofacial muscle pain. J Orofac Pain. 1997;11(2):139–146.
5. Gordon S. Comparative efficacy of piroxicam versus placebo for temporomandibular
pain. J Dent Res. 1990;69:S83.