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Pain Drawings: An Important Tool for Health Care Practitioners

Last year we shared with you a study in which investigators found patients with more severe and chronic TMD are likely to experience other persistent pain conditions in other parts of the body, seemingly unrelated to problems in the jaw or face. Yet patients often do not mention these "overlapping" or "comorbid" pain conditions when they see a dentist or health care provider.

Primary Temporomandibular Disorders and Comorbid Conditions

The aim of this study is to evaluate the distribution of the most common comorbid conditions associated with chronic temporomandibular disorders, and the pharmacological agents which play an integral role in the overall management of temporomandibular joint disorders. Abstract: INTROD

Overdiagnosis and Unnecessary Therapy

Many dental practitioners continue to use radiographic or magnetic resonance imaging (MRI) findings in the temporomandibular joint (TMJ) as the sole means of establishing that there is a pathology present that requires treatment.

TMD Self-Management Programs

Self-management (SM) programs in temporomandibular disease (TMD) are a core component of pain management of TMD throughout its course and are often given to patients as a first essential step after diagnosis.

Honor Families Who Bravely Battle TMD

If you haven't done so already, please join me in making a year-end contribution to The TMJ Association (TMJA) in the honor of families like mine and yours who bravely battle this disease each and every day. Since my daughter, Alexandra, b

Good News...Exercise Improves Disc Displacement

  • Dec 26, 2013

A recent study conducted at the Tokyo Medical and Dental University found that therapeutic exercise brings earlier recovery of jaw function compared with splints!

Randomized Clinical Trial of Treatment for TMJ Disc Displacement

Abstract:

Of the various conservative treatment modalities available for temporomandibular disorders, we believe that therapeutic exercise has a good prognosis, especially for anterior disc displacement without reduction. Since its effectiveness has not been extensively evaluated, we conducted a comparative study to verify the hypothesis that treatment efficacy would not differ for exercise and occlusal splints. Fifty-two individuals with anterior disc displacement without reduction were randomly assigned to a splint or a joint mobilization self-exercise treatment group. Four outcome variables were evaluated: (i) maximum mouth-opening range without and (ii) with pain, (iii) current maximum daily pain intensity, and (iv) limitation of daily functions. All outcome variables significantly improved after 8 weeks of treatment in both groups. In particular, the mouth opening range increased more in the exercise group than in the splint group. This result demonstrates that therapeutic exercise brings earlier recovery of jaw function compared with splints.

Treatment Procedures:

All participants received a verbal explanation of their pathological conditions regarding jaw function based on x-ray and MRI findings, and a general self-care protocol such as good posture, soft diet, teeth apart, etc. 

Participants in the splint group wore a maxillary stabilization appliance while sleeping at night. The splint was 1.5-mm-thick hard, clear acrylic sheet that was vacuum-adapted to the maxillary cast. The splint was adjusted to ensure occlusal contact of all mandibular teeth in centric relation and mandibular canine guidance in eccentric movement.

In the exercise group, participants performed manual jaw-opening exercises by themselves, according to the following protocol: As a warm-up, the individual repeated small mouth-opening and closing movements several times. Then, the individual placed his/her fingertips on the edge of the mandibular anterior teeth and slowly pulled the mandible down until pain occurred on the TMJ-affected side. This mouth-opening position was held for 30 sec. Three cycles of this stretching movement were defined as a single set. The participant performed 4 sets per day, one after each meal and one while bathing.

All participants in both groups were prescribed a non-steroidal anti-inflammatory drug (Amfenac sodiu, Fenazox, Meiji Sika Co., Tokyo, Japan; 150 mg) 3 times every day, and were followed up at 4 and 8 weeks after the start of treatment. No significant adverse effect was reported resulting from either treatment.

TMJ Disorders

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