TMJ Treatment Cost

Typical costs:

• For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays or coinsurance of 10%-50%. In some cases, health insurance plans and dental insurance plans do not cover TMJ treatment. For example, most Aetna[1] HMO plans exclude it, and the plans that do cover it have restrictions and require requests for surgery to be approved by the insurer's oral and maxillofacial surgery patient management unit. Some states require coverage or require that insurance companies offer the option of coverage. The TMJ Association offers a list of state insurance requirements[2] .
• For patients not covered by health insurance, treatment for TMJ can cost less than $500 for rest, pain relievers and cold therapy; it can cost $50-$300 per session -- or up to several hundred dollars or more -- for physical therapy; and it can cost up to $2,000 or more for a stabilization splint. Surgery typically is not recommended, but can range from more than $5,000-$7,000 or more for arthroscopy to about $40,000-$70,000 or more for total joint replacement.
• For example, Drugstore.com charges about $10-$12 for a one-month supply of a generic tricyclic antidepressant such as nortriptyline[3] or amitriptyline, which are sometime prescribed to relieve chronic pain. And Drugstore.com charges $6-$60 for cold therapy wraps[4] . Physical therapy typically costs from $50-$350 per session. And, according to the TMJ Association[5] , a stabilization splint can cost up to several thousand dollars, including the exam and fitting. Patients at HealthBoards.com[6] report costs of $1,800-$2,000 for splints/orthotics.
• Saint Elizabeth Regional Medical Center[7] in Nebraska charges about $5,300 for arthroscopy of the temporomandibular joint, not including doctor fee; it can be used to detect underlying problems, remove scarring that might contribute to TMJ pain or repair damaged tissue. On the TMJ Association[8] website, patients report costs of more than $7,000 for arthroscopy. A patient at TMJ Talk[9] forum reports a total cost of $38,000 for a total joint replacement, while a patient on the TMJ Association[10] website reports a cost of $67,000.

• According to the National Institutes of Health, a patient typically can relieve symptoms and manage (but not cure) the disorder by taking simple steps such as: temporarily eating only soft foods, using cold therapy, avoiding chewing gum and other extreme movements, and practicing stress reduction techniques and gentle stretching under the guidance of a doctor or physical therapist.
• A doctor also can recommend over-the counter pain medication or prescribe stronger pain medication, muscle relaxants or tricyclic antidepressants[11] , which have been shown to relieve pain in some patients with TMJ.
• A doctor might recommend a stabilization splint[12] , but, according to the National Institutes of Health, studies on effectiveness are inconclusive. The National Institute of Dental and Craniofacial Research offers an overview[13] of TMJ and treatment. According to the National Institutes of Health[14] , symptoms of TMJ often will go away over time on their own or with conservative treatment.

• Some patients seek alternative therapies such as acupuncture. According to the TMJ Association[15] , studies have not definitively shown that it works, but some patients report relief. Acupuncture typically costs about $50-$70 per session.

• Many hospitals and doctors give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[16] in California offers a 35% discount.

• A primary care physician can examine the patient, look for other causes of symptoms and make an initial TMJ diagnosis -- or refer the patient to a specialist. However, because the treatment of TMJ is not a recognized specialty by either the American Medical Association or American Dental Association, and because there is a lack of scientific research about the effectiveness of various treatments, the TMJ Association[17] recommends getting a confirmation of the diagnosis and several opinions before proceeding with any treatment.
• According to the National Institutes of Health[18] , a patient might need to consult a primary care physician, a dentist and possibly an ENT specialist. The American Dental Association offers a dentist locator[19] ; the American Academy of Otolaryngology offers an ENT doctor finder[20] . According to the National Institutes of Health[21] , patients should be cautious about surgery or any other treatment that permanently alters the bite.

1.  www.aetna.com/cpb/medical/data/1_99/0028.html
2.  www.tmjarchive.org/insurance3.asp
3.  www.drugstore.com/nortriptyline-hcl/pamelor/10mg-capsules/qxn00591578601
4.  www.drugstore.com/fsa-store/cold-and-hot-packs/i-c-e-down/qxg59965-e180f95
5.  tmj.org/site/content/splints
6.  www.healthboards.com/boards/archive/index.php/t-851605.html
7.  tp.chi.acelogicus.net/nese/Default.aspx
8.  www.tmjarchive.org/contact.asp
9.  tmjtalk.yuku.com/topic/710/TMJ-prothesis-surgery#.TqrguWC1msI
10.  www.tmjarchive.org/contact.asp
11.  www.mayoclinic.com/health/pain-medications/PN00044
12.  tmj.org/site/content/splints
13.  www.nidcr.nih.gov/OralHealth/Topics/TMJ/TMJDisorders.htm
14.  www.nlm.nih.gov/medlineplus/ency/article/001227.htm
15.  tmj.org/site/content/acupuncture
16.  www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
17.  www.tmjarchive.org/treatments1.asp
18.  www.nlm.nih.gov/medlineplus/ency/article/001227.htm
19.  www.mouthhealthy.org/en/find-a-dentist.aspx
20.  www.entnet.org/
21.  www.nlm.nih.gov/medlineplus/ency/article/001227.htm

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