Vibroacoustic therapy to treat pain in the temporomandibular joint

Pain in the temporomandibular joint (TMJ) affects about 4.8 % of the United States population. Pain is the most common symptom of TMJ and the chief reason patients seek care. Conventional treatments range from noninvasive therapies including physical therapy, dental guards and occlusal splints to interventions such as corticosteroid injections and surgery. At present, the most common challenge to healthcare providers in patients presenting with TMJ is the reduction of pain. Vibroacoustic therapy (VAT) is noninvasive and safe as a potential treatment for TMJ pain. VAT involves low-frequency vibrations from 30 to 120 + Hertz. Biological mechanisms to explain a beneficial effect include enhanced blood circulation, decreased swelling, and promotion of muscle relaxation. VAT also appears to have beneficial effects on skin and bone conduction as well as stimulates relaxation responses and the release of nitric oxide. Clinical studies of VAT to reduce TMJ pain are promising but limited in design and sample sizes. The most reliable design strategy to detect the most plausible small to moderate benefit of VAT on TMJ pain is a randomized trial. This trial should be of sufficient size, dose, and duration. If VAT has a favorable benefit-to-risk ratio, then it would represent a safe, noninvasive, feasible and cost-effective means to treat TMJ.