I think i have severe tmj. what are my options for treatment?

Find the causes: A balance exists between how your teeth fit together, how the muscles move the lower jaw to the upper jaw, how the joints function and how the upper quadrant is able to function or need to compensate. Joints do not go bad without a reason(s). It is essential to find what should be the best functional position and then determine why you don't function as designed. Use conservative steps first!

Stay simple: Much of what dr. K says is correct. My approach is to diagnose the problem first, getting the muscles relaxed with a bite appliance is key. Once feeling better, of you want to get rid of the 24/7 appliance, consider orthodontics to that position, reconstruction, or tooth reshaping (coronplasty), depending on the severity of the bite discrepancy.

Parafunction: Most of the time oral parafunctions such as sleep bruxism and daytime clenching are the major causes for the TMJ pain. Changing the occlusion or bite usually doesnt not take control over these parafunctions. Therefore irreversible treatments are not supported today by scientific evidence and not recommended by the american academy of orofacial pain. Diagnosis is the first step. A conservative.

A few things: Depends on symptoms, and cause of symptoms. 3 signs of TMJ dysfunction: joint noises, joint pain & limited oral opening. Self treat with soft diet, jaw exercises, massage, heat/cold, OTC pain meds. A splint or physical therapy would be next. Occasionally muscle relaxants, biofeedback. Xrays are done for diagnosis. Surgery usually reserved for serious symptoms not responsive to other treatments.