I have been told i have severe tmj and my joint is sitting bone to bone. what does this mean and what treatments are out there? my tmj is painful.

Intervention: Usually if you have failed medical treatment including dental appliances, anti inflammatories , muscle realaxants and local injections, you might need a surgeon experienced in this, look into arthroscopy and very rarely, may need replacement of joint.

THere's hope: This means the disc is either damaged or displaced. More info would be helpful. Either way, the goal of treatment is to decompress the joint and allow jaw closure along an optimized trajectory. If the disc is displaced, enough space can be developed with a bite appliance, called an orthosis, that the disc can return to and maintain its position. Try that before considering surgery.

Bone to Bone?: Have you had a MRI taken? There is an articular disk about the jaw joints (right and left) that acts as an insulator and protection from bone on bone. To really know if the disk has degenerated, should consider asking for a mri. May need physical therapy and/or some type of mouthpiece.

Cartilage damage : If you are told that you are articulating bone on bone, it means that the cartilaginous disc is degenerated or displaced so that its proper function is impaired. Advanced imaging: MRI or 3d ct scans can provide necessary info. Surgery is not often done as it may cause more problems with scar tissue. Arthrocentesis or cleansing of the joint may be a better option. Occlusion needs stabilization.

See TMJ expert: Complicated problem. See TMJ expert. Any dentist can be a TMJ expert with the proper training and experience. Most commonly, oral surgeons, prosthodontists, and orofacial pain specialists. Ask your MD, your dentist and your dental society for referrals.