Very good and tough questions....
Most people with TMD go for treatments because of the PAIN and the bad symptoms. What is your pain level WITHOUT the meds?
If your main concern is the bone loss I would see a rheumatologist. They are experts with people with conditions and diseases affecting joints, muscles, and bones. I have to see one too because of my arthritis.
I would also still get an MRI. X-rays, CAT scans can not pick up the fine detail of the soft tissue.
I take Aleve if I have any pain. I take Xanax for the stress and anxiety. I wear a stabilization splint (hard acrylic mouth guard) at night on my top teeth to prevent grinding and to relax my jaw joints. I only chew soft foods, and I never tear food with my teeth. I also drink lots of water, good for the joints and take vitamins for people that have arthritis and joint issues.
I can't say if the stuff I'm doing is making any difference but since I have almost no pain or symptoms it's not making it worse.
I too am concerned with what is happening to my jaw joints and bone loss but I am going to use my MRI and X-rays as a gauge to see how things are progressing. I also have to wait to see the rheumatologist. I'll let you know what he says....
For now think positive! Go on vacation and try not to think of TMD so much. I know it is hard but you have to. You control your life not your jaw!!!
Keep me posted...