What could be the best treatment for tmj chronic arthritis in case ibuprofen pills and heat packs don't work any more?then you very much =o)

Dentist evaluation: Tmj issues can be complex. If you have a displaced articular cartilage, you may need a splint designed to recapture it. If the issue is primarily musculo skeletal, you may need a regimen of physical therapy. It's possible surgery may be required but these decisions require diagnosis by an experienced dentist. The usual process starts with minimal invasiveness and progresses under supervision.

Oral Surgeon : There are some oral surgeons and dentists who treat TMJ problems with cortisol injections and steroids-call around in your area. In addition to heat and ibuprophen, avoid caffeine and chewing gum.

Same: The arthritic joint should be treated as an arthritis like any other part of the body. But, if there is degeneration of the joint/joints, then a realignment of the joints with a mouthpiece or therapy may be necessary to hopefully prevent additional breakdown.

TMJ expert: You need a specialist. See a 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.