Materiały źródłowe

• #1 TMJ Disorders: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/15066-temporomandibular-disorders-tmd-overview

  TMJ dysfunction (TMD) causes pain and tenderness in your jaw joints and surrounding muscles and ligaments. TMJ treatment varies from person to person and may include medication, physical therapy, custom mouth guards and jaw surgery. […] TMJ (temporomandibular joint) disorders are a group of over 30 conditions that affect your jaw joint and surrounding muscles. […] TMJ dysfunctions are conditions affecting your jaw joints and surrounding muscles and ligaments. These conditions can cause several issues, including jaw pain, headaches and difficulty opening and closing your mouth. […] Between 5% and 12% of the general adult population have some form of TMJ disorder. The condition is twice as common in women. People between the ages of 20 and 40 are most likely to develop TMD. […] TMJ symptoms vary widely and may include: Jaw pain. Facial pain. Shoulder or neck pain. Stiffness in your jaw. Difficulty opening or closing your mouth. Jaw popping or clicking. Headaches. Migraines. Earaches. Toothache. Tinnitus (ringing in your ears). A change in the way your teeth fit together (malocclusion).

• #2 TMD (Temporomandibular Disorders) Causes, Symptoms, Diagnosis, Treatment | National Institute of Dental and Craniofacial Research

  https://www.nidcr.nih.gov/health-info/tmd

  Temporomandibular disorders (TMDs) are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. […] Many TMDs last only a short time and go away on their own. However, in some cases they can become chronic, or long lasting. […] Temporomandibular disorders are twice as common in women than in men, especially in women between 35 and 44 years old. […] Because evidence is lacking for the majority of TMD treatments, experts strongly recommend staying away from treatments that cause permanent changes to the jaw joints, teeth, or bite; or that involve surgery. […] The goal of physical therapy is to maintain, improve, or bring back movement and physical function. […] Certain behavioral health approaches, usually offered by a psychologist, have been shown to help manage TMDs.

• #3 Temporomandibular disorders in adults – UpToDate

  https://www.uptodate.com/contents/temporomandibular-disorders-in-adults

  Temporomandibular disorders (TMD) are commonly encountered by primary care providers. […] The goals of TMD management are to alleviate pain and to improve jaw function and quality of life. […] TMD is associated with substantial morbidity, affecting quality of life and work productivity. […] TMD patients have also been shown to use health care services at a higher rate, with a mean health care expenditure that is 1.6 times higher when compared with non-TMD individuals. […] Initial management for all patients includes patient education and self-care. […] Evaluate and treat contributory factors such as physical therapy for musculoskeletal causes, orthotics for musculoskeletal symptoms or bruxism, and biobehavioral management for psychological contributors. […] Adjunctive pharmacologic therapy may include NSAIDs for acute management and tricyclic antidepressants for persistent pain. […] Interventional management may be necessary for some patients with arthritis of the TMJ or refractory temporomandibular disorders.

• #4 TMJ Disorders – UF Health

  https://ufhealth.org/conditions-and-treatments/tmj-disorders

  Temporomandibular joint and muscle disorders (TMJ disorders) are problems that affect the chewing muscles and joints that connect your lower jaw to your skull. […] Many TMJ-related symptoms are caused by the effects of physical stress on the structures around the joint. […] Poor posture can also be an important factor in TMJ symptoms. […] Many people end up having „trigger points.” These are contracted muscles in your jaw, head, and neck. Trigger points can refer pain to other areas, causing a headache, earache, or toothache. […] Symptoms associated with TMJ disorders may be: Biting or chewing difficulty or discomfort, Clicking, popping, or grating sound when opening or closing the mouth, Dull, aching pain in the face, Earache, Headache, Jaw pain or tenderness of the jaw, Locking of the jaw, Difficulty opening or closing the mouth.

• #5 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  A similar push toward the early diagnosis and management of other factors that cause or contribute to TMDs may decrease future morbidity. […] Prevention must not stop at the onset of a TMD. […] This secondary prevention approach requires close collaboration between the individual and his or her health care professional to avoid over-treatment, iatrogenic harm, or an aggravation of a TMD and to identify self-care or other interventions that may decrease the negative impact of the disorder on that individual. […] Following the publication of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a central concern was whether the DC/TMD in its present form is appropriate for clinical use. […] A clinical assessment for TMDs should include talking with the patient to hear the history of the symptoms and problems, an examination, special tests such as imaging when indicated, and psychosocial assessment.

• #6 Temporomandibular Disorders and Pain Syndromes | Doctor

  https://patient.info/doctor/temporomandibular-joint-dysfunction-and-pain-syndromes

  Temporomandibular disorders (TMDs) are a group of conditions affecting the temporomandibular joint (TMJ), masticatory muscles, and associated structures. These disorders are characterised by shared symptoms, including TMJ pain, tenderness of the masticatory muscles, headache, limited mouth opening, and joint noises (eg, clicking, popping, or crepitus).1 […] TMDs may also be classified based on the duration of symptoms. Acute TMD pain is typically of short duration, self-limiting, and often associated with prolonged jaw opening, such as following dental treatment or trauma. Chronic TMD pain, on the other hand, is defined as pain persisting for more than three months.1 […] Diagnosis is based on the history and physical examination. The assessment of patients suspected of having TMD should follow a biopsychosocial approach. It should assess the impact of symptoms on the individual’s quality of life, identify associated comorbid conditions, and consider psychological factors contributing to the symptoms.

• #7 Temporomandibular Joint Disorders | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/temporomandibular-joint-disorders

  Temporomandibular joint (TMJ) disorders are very common, affecting over 10 million people in the United States. […] UCSF’s oral and maxillofacial surgeons offer a full range of diagnostic services, as well as surgical and non-surgical treatments for TMJ disorders. Patients also have access to our Orofacial Pain Center, which specializes in conditions that cause orofacial pain, such as TMJ. […] Diagnosing TMJ disorders is often complex and therefore should be conducted by oral and maxillofacial surgeons experts in the field of the mouth, teeth and jaw. An accurate diagnosis of TMJ is very important before starting a treatment plan. […] There are a variety of treatments available for TMJ disorders, ranging from pain medications and relaxation techniques to splints and surgery. […] At UCSF, a physical therapist is also available on-site to provide physical therapy services designed for patients suffering from TMJ.

• #8 TMJ Disorders: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/15066-temporomandibular-disorders-tmd-overview

  Theres no singular cause of TMD. Rather, it can be a result of many different factors or a combination of factors. […] TMJ dysfunction can contribute to a range of complications, including chronic pain, limited chewing function and bruxism-related wear and tear. […] The TMJ treatment thats right for you depends on several factors, including the underlying cause and the severity of your pain. Providers usually try noninvasive options first, like medications or nonsurgical treatments. If your symptoms dont improve, you might need jaw surgery. […] Nonsurgical treatment options include: Mouth guards. Dental appliances like oral splints or mouth guards can place your jaw in a more favorable position or help reduce the effects of grinding and clenching. […] If medications and nonsurgical therapies dont work, you might need surgery.

• #9

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3722

  Temporomandibular disorders (TMDs) are problems with the muscles and joints that connect your jaw to your skull. The disorders cause pain when you talk, chew, swallow, or yawn. You may feel this pain on one or both sides. […] TMDs are often caused by tight jaw muscles. The tightness can be caused by clenching or grinding your teeth. This may happen when you have a lot of stress in your life. […] If you lower your stress, you may be able to stop clenching or grinding your teeth. This will help relax your jaw and reduce your pain. Your doctor may suggest a dental splint. Splints can help reduce teeth grinding and clenching. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems.

• #10 Self-Care for Temporomandibular Disorders (TMD) | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/self-care-temporomandibular-disorders-tmd

  You have temporomandibular disorder (TMD). This term describes a group of problems related to the temporomandibular joint (TMJ) and nearby muscles. Treatment will get your jaw back to normal function. But your care doesnt end there. Once youve had TMD, its important to prevent reinjury. […] Make it a habit to assess your body a few times each day. […] If you answer yes to any of the questions above, you need to take action. Changing your posture or taking a short break can help prevent or relieve TMD symptoms. […] Dont eat hard or chewy foods. Even if you feel fine, eating such foods can set off symptoms again. […] Be aware of your body. Dont ignore TMD symptoms. The nagging pain in your neck or jaw may be a sign that you need care. […] Keep follow-up appointments. Be sure to keep all appointments with your healthcare team. […] Stress is a key factor in TMD. Stress can make you clench your muscles or grind your teeth. […] Activity helps the body in many ways. You stay looser and more relaxed. It also helps keep muscles and tissues conditioned. That way you can heal faster and make reinjury less likely.

• #11 Temporomandibular joint dysfunction – symptoms, treatment and causes | healthdirect

  https://www.healthdirect.gov.au/temporomandibular-joint-dysfunction

  One way to avoid TMJ dysfunction is to manage your stress levels. […] If your TMJ dysfunction does not get better after a few weeks, chronic jaw pain can become distressing. […] You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

• #12 Temporomandibular joint dysfunction – Wikipedia

  https://en.wikipedia.org/wiki/Temporomandibular_joint_dysfunction

  TMD can be difficult to manage, and since the disorder transcends the boundaries between several health-care disciplines in particular, dentistry and neurology, the treatment may often involve multiple approaches and be multidisciplinary. Most who are involved in treating and researching TMD now agree that any treatment carried out should not permanently alter the jaw or teeth, and should be reversible. […] Given the important role that psychosocial factors appear to play in TMD, psychosocial interventions could be viewed to be central to management of the condition. There is a suggestion that treatment of factors that modulate pain sensitivity such as mood disorders, anxiety and fatigue, may be important in the treatment of TMD, which often tends to attempt to address the pain directly.

• #13 Temporomandibular Disorders (TMD)

  https://www.aadocr.org/science-policy/temporomandibular-disorders-tmd

  The AADOCR recognizes that temporomandibular disorders (TMDs) encompass a group of musculoskeletal and neuromuscular conditions that involve the temporomandibular joints (TMJs), the masticatory muscles, and all associated tissues. The signs and symptoms associated with these disorders are diverse, and may include difficulties with chewing, speaking, and other orofacial functions. […] It is strongly recommended that, unless there are specific and justifiable indications to the contrary, treatment of TMD patients initially should be based on the use of conservative, reversible and evidence-based therapeutic modalities. Studies of the natural history of many TMDs suggest that they tend to improve or resolve over time. […] Professional treatment should be augmented with a home care program, in which patients are taught about their disorder and how to manage their symptoms.

• #14 Self Care – The TMJ Association

  https://tmj.org/living-with-tmj/self-care/

  If you have pain when you chew or yawn, you know the discomfort of TMJ disorders. You may find relief with some or all of the following therapies which can be managed at home. […] Most people with TMJ have relatively mild or periodic symptoms which may improve on their own within weeks or months with simple home therapy. You may find the following suggestions helpful in easing your TMJ symptoms. […] A survey of TMJ patients, conducted by the TMJA, showed the most frequently used intervention (65% of respondents) was thermal therapy (hot or cold compresses) to the jaw. 74% of the respondents said that use of compresses resulted in a reduction of their symptoms. […] Routine maintenance of the teeth and gums is important in the overall management of TMJ disorders, as it helps to reduce the risk of dental disease and the need for invasive dental treatments. Our guide, Temporomandibular Disorders Dental Care and You provides oral hygiene self-care tips that you can do at home, as well as suggestions for dental appointments.

• #15

  https://www.tmjtreatmentcentersofwi.com/management-treatment-of-tmd

  Physical therapy modalities are often required to return the muscles to normal comfort and function. These might include moist heat, ultra-sound, massage, stretches, transcutaneous electro-neural stimulation (TENS) or electro-galvanic stimulation (EGS). […] Such conservative management techniques have proven to be safe and effective in the vast majority of TMD cases. While rarely needed, surgery is sometimes performed when conservative treatment has failed to improve comfort and function. However, even when TMD symptoms are long standing and severe, most patients rarely require invasive treatments designed to permanently change the bite or repositioning of the jaw. […] There is no reason to live with the pain. The risks of leaving TMD untreated simply aren’t worth it. […] For very mild cases, or prior to being able to see a TMD specialist, there are self-management actions you can do for yourself, such as: Limit your jaw opening movement to about two finger widths, Avoid chewing hard or very chewy food, or gum, Cut food into smaller pieces, Massage painful facial muscles, Use cold packs or moist heat packs, Avoid grinding clenching your teeth, Practice keeping teeth apart and lips together, Avoid chewing non-food items, ie: pencils, fingernails, etc., Avoid playing musical instruments that put pressure on your jaw, Learn stress management and relaxation techniques, Keep a diary of your pain, and anything, or any time of the day or night, that makes it better or worse.

• #16 TMD Self-Care: Steps For Managing Your Symptoms At Home

  https://www.dentalcareburke.com/tmd-self-care-steps-for-managing-your-symptoms-at-home

  There’s a strong link between bad posture and TMD pain. […] Bad habits like smoking can wreak havoc on our bodies. TMD pain is often affected by several bad oral habits, including the following: Nail-biting, Gum chewing, Clenching or grinding teeth, Chewing the inner cheeks or lips, Pushing the tongue against the teeth. […] Acupuncture is an ancient, traditional Chinese practice for pain reduction. […] If you’re going through a bout of pain, eating the right food can provide relief. […] TMD exercises have the same function as full-body exercises: to maintain the muscles. […] Visiting your dentist is essential for keeping your gums and teeth healthy when struggling with TMD. […] Practice TMD self-care to reduce the severity and frequency of symptoms. […] We can help you manage your TMD symptoms and provide treatments for the pain.

• #17

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3722

  You may also be able to do some things at home to feel better. But if none of this works, your doctor may prescribe medicine to help relax your muscles and control the pain. […] Put either an ice pack or a warm, moist cloth on your jaw for 15 minutes several times a day. […] Make eating easy on your jaw. Choose softer foods that are easy to chew like eggs, yogurt, or soup. Avoid hard foods that cause your jaws to work very hard. […] Manage stress. You may be clenching or tightening your muscles when you are under stress. […] Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). […] Call your doctor or nurse advice line now or seek immediate medical care if your jaw is locked open or shut or it is hard to move your jaw. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if your jaw pain gets worse.

• #18 Temporomandibular Disorders (TMD) Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/temporomandibular-disorders-tmd/

  Physical therapy can help if your symptoms are caused by tight muscles. Physical therapy can help you stretch and release tight muscles and scar tissue. […] Your doctor may suggest medicines. In some cases, the doctor may inject numbing medicine into the spot that hurts. […] Most people don’t need dental work or surgery. Surgery may be used if you have structural problems in your jaw joint. […] Put an ice pack or a warm, moist cloth on your jaw for 15 minutes. Do this several times a day. Try switching back and forth between moist heat and cold. […] Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label. […] If it doesn’t cause pain, practice relaxing your jaw. Gently open and close your mouth. Move your jaw straight up and down. Do this for a few minutes every morning and evening. Watching yourself in a mirror can help.

• #19 Self-Care for Temporomandibular Disorders (TMD)

  https://healthlibrary.wjmc.org/library/diseasesconditions/Adult/Women/3,89755

  If you answer yes to any of the questions above, you need to take action. Changing your posture or taking a short break can help prevent or relieve TMD symptoms. […] Many people get used to ignoring pain. But pain is a signal that your body needs care. To maintain your TMJ health: Don’t eat hard or chewy foods. Even if you feel fine, eating such foods can set off symptoms again. Be aware of your body. Don’t ignore TMD symptoms. The nagging pain in your neck or jaw may be a sign that you need care. Keep follow-up appointments. Be sure to keep all appointments with your healthcare team. […] Stress is a key factor in TMD. Stress can make you clench your muscles or grind your teeth. It can also affect your sleep, reducing your bodys ability to heal. Here are a few tips to manage stress: Learn ways to relax. Try listening to music or gently stretching. Take a few slow deep breaths. Or close your eyes and imagine a place or object that is calming. Get plenty of rest and sleep. Set goals you know you can attain. Make time for people and things you enjoy. Ask for help if you need it. Friends and family can run errands and cook meals for you. Talk with a counselor or your doctor about your stress.

• #20 Temporomandibular (TMJ) Disorders and Headache | AMF

  https://americanmigrainefoundation.org/resource-library/temporomandibular-disorders/

  A temporomandibular disorder involves the chewing muscles, temporomandibular joint, and connected structures. […] The signs and symptoms of TMD are often transient and self-limiting. Simple and reversible treatments have to be preferred over irreversible procedures. […] The goals of treatment for TMD are to decrease pain and to restore normal function. […] Five basic treatment tools include a) patient education and self care, b) cognitive and behavioral intervention, c) pharmacologic management, d) physical medicine techniques, e) surgery. […] The goals of treatment for TMD are to decrease pain, and to restore normal function. Because the signs and symptoms of TMD can be transient and self-limiting, simple and reversible treatments have to be preferred over complicated and irreversible procedures. These goals may be achieved through a structured, time limited program, which addresses the physical disorder and the perpetuating factors. The five basic areas that should be considered are summarized below and include a) patient education and self care, b) cognitive and behavioral intervention, c) pharmacologic management, d) physical medicine techniques, and e) surgery.

• #21 Temporomandibular (TMJ) Disorders and Headache | AMF

  https://americanmigrainefoundation.org/resource-library/temporomandibular-disorders/

  Satisfactory management requires an explanation and reassurance. […] Drugs are used in the management of TMD to control symptoms. These include anti-inflammatories (both steroidal and non steroidal), muscle relaxants, and antidepressants and antiepileptic agents. […] Physical therapy modalities provide a popular and safe approach to the management of TMD’s. Treatment goals are generally based on physical rehabilitation of the joint by reducing joint inflammation, restoring joint mobility, and elimination of muscle pain through heat and stretching. […] Given the self limiting nature of most TMD, surgical intervention is rarely warranted. Joint injection with corticosteroid is frequently part of treatment programs, but lacks literature support for its value. […] TMD are a collection of clinical entities that are often very painful and disabling. Yet, they are self-limiting and usually respond to conservative therapy. Basic principals of management to reduce pain and restore range of motion will reduce disability and often contribute to reducing primary headache if it coexists.

• #22 Temporomandibular Disorders (TMD) | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/temporomandibular-disorders-tmd

  Dental splints are a common treatment for TMDs. Splints are usually pieces of plastic that fit between the upper and lower teeth. They help reduce grinding and clenching. […] Your doctor may suggest physiotherapy if your symptoms are related to muscle tension. This treatment can help you stretch and release tight muscles and scar tissue. […] Most people don’t need permanent dental work or surgery. But surgery may be used if you have severe structural problems in your jaw joint.

• #23 Guide | Physical Therapy Guide to Temporomandibular Disorder | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-temporomandibular-joint-disorder

  Soft-tissue release. Your physical therapist may use hands-on treatments to mobilize your soft-tissue. […] Joint mobilization. Your physical therapist will address any stiffness in your neck and jaw to help restore movement of your TMJ. […] Therapeutic exercises. Your physical therapist will teach you specific exercises to repeat several times throughout the day. […] Stress management. Your physical therapist can teach you ways to help you manage stress and offer psychological support and positive encouragement. […] A physical therapist can help you avoid a recurrence or worsening of TMD symptoms by educating you on: How to sit, stand, and work with a proper posture. […] You may want to see a physical therapist with clinical expertise in the head/neck/TMJ area. […] All physical therapists are prepared through education and experience to identify TMD and provide appropriate treatment.

• #24 Guide | Physical Therapy Guide to Temporomandibular Disorder | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-temporomandibular-joint-disorder

  Temporomandibular disorder, or TMD, is a common condition that affects people of all ages and genders. […] TMD can involve problems with the joints of the jaw (temporomandibular joint, or TMJ) or the muscles that move the jaw. […] Conservative management, including physical therapy, is the recommended first-line approach for TMD. […] Physical therapists use an evidence-based approach to evaluate and treat TMD, aimed at providing people with the tools to manage symptoms and improve function. […] Your physical therapist can help you decrease your pain and restore jaw function. […] Your physical therapy program may include: Education. Your physical therapist will discuss the cause of your TMD and educate you about: Proper posture and body mechanics. […] Modalities. Your physical therapist will determine which treatments are best for you.

• #25

  https://www.tmjtreatmentcentersofwi.com/management-treatment-of-tmd

  Medications may be considered in the management of patients with orofacial pain, including TMD. The choices often reflect the acute or chronic pain levels in each individual patient and the presenting signs and symptoms following a diagnosis. […] The most widely used types of medications in the management of TMD are analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, benzodiazepines, muscle relaxants, and low-dose antidepressants. […] A common reaction to an untreated joint problem anywhere in the body, namely the temporomandibular joint in this instance, is what is referred to as muscle guarding which is the body’s natural response is to protect or guard itself from further injury. […] Effective treatment of TP pain first requires stabilizing the jaw joint which is causing the muscles to remain guarded which is accomplished by the use of an intraoral device often called a splint which when in place, will reduce pressure within the TM joints thereby reducing the need to for the muscles to remain guarded.

• #26 Get Temporomandibular Joint (TMJ) Disorder Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/temporomandibular-joint-disorder-treatment

  Imaging tests are an important part of diagnosing temporomandibular joint disorders. […] At Cleveland Clinic, we believe in a team-based approach to care. […] Well start your TMJ disorders treatment with less invasive therapies first like lifestyle changes and stress management before turning to surgery. […] Making simple behavioral changes can sometimes be enough to relieve TMJ pain. […] Physical therapists can press on tight tissue to release tension and provide other therapies to lessen pain. […] Nonsteroidal anti-inflammatory medications (NSAIDs), like aspirin, ibuprofen (Motrin, Advil) or naproxen (Aleve), can relieve TMD pain and swelling. […] We offer customized mouth guards, splints and other devices to help with bruxism (teeth grinding) or mild bite problems. […] Transcutaneous electrical nerve stimulation (TENS) and radio wave therapy use gentle, low-level electrical currents to relax your jaw muscles. […] If youve tried other treatment options and you still have severe pain, it may be time to consider surgery. […] The painful pop could be the sign of a bigger problem, like temporomandibular joint (TMJ) disorder.

• #27 Diagnosis and Treatment of Temporomandibular Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0315/p378.html

  Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, and surrounding musculature and osseous components. TMD affects up to 15% of adults, with a peak incidence at 20 to 40 years of age. […] Most patients improve with a combination of noninvasive therapies, including patient education, self-care, cognitive behavior therapy, pharmacotherapy, physical therapy, and occlusal devices. Nonsteroidal anti-inflammatory drugs and muscle relaxants are recommended initially, and benzodiazepines or antidepressants may be added for chronic cases. Referral to an oral and maxillofacial surgeon is indicated for refractory cases. […] Supportive patient education is the recommended initial treatment for TMD. Adjunctive measures include jaw rest, soft diet, moist warm compresses, and passive stretching exercises.

• #28 Temporomandibular Joint (TMJ) Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/809598-treatment

  Some patients find benefit from ultrasonic therapy. This provides deep heat to the area of tenderness and also has non-thermal effects. Transcutaneous electrical nerve stimulation (TENS) has also been used to reduce pain. […] Low-intensity laser therapy has been shown to reduce pain in TMJ syndrome. […] In view of the role that psychological factors play in TMJ syndrome, measures such as cognitive-behavioral therapy and bio-behavioral approach may be beneficial. […] Pharmacologic therapy for acute and chronic TMJ-related pain includes acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). […] If conservative therapies fail, or for severe acute exacerbations, intra-articular injection of local anesthetics or steroids may be used for TMJ syndrome. […] However, in a long-term study by Fricton et al, synthetic implants did not lead to an improved outcome compared with nonimplant surgical repair or nonsurgical rehabilitation. […] Offer routine follow-up care with an ear, nose, and throat (ENT) specialist, dentist, or an oral maxillofacial surgeon (OMFS). If intractable pain and/or dislocation are present, more urgent consultation may be necessary.

• #29 Temporomandibular joint dysfunction – Wikipedia

  https://en.wikipedia.org/wiki/Temporomandibular_joint_dysfunction

  Occlusal splints (also termed bite plates or intra-oral appliances) are often used by dentists to treat TMD. They are usually made of acrylic and can be hard or soft. They can be designed to fit onto the upper teeth or the lower teeth. […] Medication is the main method of managing pain in TMD, mostly because there is little if any evidence of the effectiveness of surgical or dental interventions. Many drugs have been used to treat TMD pain, such as analgesics (pain killers), benzodiazepines, anticonvulsants, muscle relaxants, and others. […] Physiotherapy (physical therapy) is sometimes used as an adjuvant to other methods of treatment in TMD. There are many different approaches described, but exercises aiming to increase the range of mandibular movements are commonly involved. […] The goals of a PT in reference to treatment of TMD should be to decrease pain, enable muscle relaxation, reduce muscular hyperactivity, and reestablish muscle function and joint mobility.

• #30 Temporomandibular Joint Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1115/p1477.html

  Pharmacologic interventions similar to those for other musculoskeletal disorders are a treatment option. […] Intra-articular injections of the TMJ with local anesthetics or corticosteroids can be used for the treatment of inflammation within the TMJ capsule. […] Dental occlusal splinting and permanent occlusal adjustment have been the mainstays of TMJ disorder treatment for years, although there is no clear evidence that malocclusion of the upper and lower teeth causes TMJ pain. […] Occluding splints, also called stabilization splints, are specially fabricated to improve the alignment of the upper and lower teeth. […] Nonoccluding splints, also called simple splints, primarily open the jaw, release muscle tension, and prevent teeth clenching. […] The Cochrane Collaboration recently reviewed permanent occlusal adjustment and occluding splint therapy for treatment of TMJ disorders.

• #31 Temporomandibular Joint Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1115/p1477.html

  Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. […] Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy. […] There is little evidence to suggest that any TMJ disorder treatment modality is superior to any other, although it is generally accepted that self-care and behavioral interventions should be encouraged for all patients, regardless of which therapies are considered. […] Many noninvasive therapies are commonly used for the treatment of TMJ disorders. […] Because most patients with TMJ disorders improve with or without treatment, these conservative therapies should be encouraged before invasive treatments are considered.

• #32 Temporomandibular Disorders (TMD) | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/temporomandibular-disorders-tmd

  Temporomandibular disorders (TMDs) is the name given to several problems with jaw movement and pain in and around the jaw joints. They cause pain when you talk, chew, swallow, or yawn. […] The focus of TMD treatment is to ease pain in the jaw joint and restore normal jaw movement. Initial treatment involves over-the-counter pain medicine and self-care at home. Splints can help reduce teeth grinding and clenching. Your doctor may suggest other treatments as well. Surgery isn’t usually done to treat TMDs. […] To prevent temporomandibular disorders (TMDs), try to reduce muscle tension in your jaw. Here are some ways you can reduce muscle tension. […] The focus of treatment of TMDs is to ease pain in the jaw joint and restore normal jaw movement. Over-the-counter pain medicine and self-care that you can do at home work well. Using techniques to relax your muscles and manage stress can also help.

• #33 Temporomandibular Joint Disorders | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/temporomandibular-joint-disorders

  Splints also called mouth guards are used to treat teeth grinding, clenching and TMJ disorders. […] In severe cases and if non-surgical therapies have not worked, surgery may be recommended. Surgery may involve repairing damaged tissue or joints, during a procedure known as arthroscopy. […] Other treatments provided at UCSF include: Pain management therapies, Acupuncture, Relaxation techniques, Biofeedback.

• #34 TMD (Temporomandibular Disorders) Causes, Symptoms, Diagnosis, Treatment | National Institute of Dental and Craniofacial Research

  https://www.nidcr.nih.gov/health-info/tmd

  Your doctor or dentist may recommend medication(s) to treat your symptoms. […] Intraoral appliances are devices that fit over the teeth. They do not change the teeth or bite. […] A complementary treatment is a non-mainstream practice used together with conventional medicine. […] Surgery should only be considered if there is destruction of the joint that cannot be fixed with other procedures. […] Remember: Before any surgery, including implant surgery, it is extremely important to get opinions from more than one doctor and to completely understand the risks.

• #35 TMJ disorders – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tmj/diagnosis-treatment/drc-20350945

  Your healthcare professional will likely discuss your symptoms and study your jaw by: […] TMJ arthroscopy also is sometimes used to treat TMJ disorder. The procedure can help with therapy, such as releasing scar tissue and removing inflammatory soft tissue and byproducts to improve TMJ symptoms and help the jaw move without pain. […] Our caring team of Mayo Clinic experts can help you with your TMJ disorders-related health concerns Start Here […] If your symptoms don’t go away, your healthcare professional may recommend treatment options, often more than one to be done at the same time. […] Along with other treatments that don’t involve surgery, these medicine options may ease the pain related to TMJ disorders: […] Therapies for TMJ disorders that don’t involve drugs include: […] When other methods don’t help, your healthcare professional might suggest procedures such as:

• #36 Temporomandibular Disorders – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/1_99/0028.html

  This Clinical Policy Bulletin addresses temporomandibular disorders. […] For plans that cover treatment of temporomandibular disorder (TMD) and temporomandibular joint (TMJ) dysfunction, requests for TMJ surgery require review by Aetna’s Oral and Maxillofacial Surgery patient management unit. […] Aetna considers physical therapy to be a medically necessary conservative method of TMD/TMJ treatment. […] Aetna considers relaxation therapy, electromyographic biofeedback and cognitive behavioral therapy medically necessary for treatment of TMJ/TMD. […] Aetna considers intra-articular corticosteroid injection medically necessary for the treatment of TMJ disorder. […] Medically necessary surgical procedures for TMJ/TMD include therapeutic arthroscopy, arthrocentesis, condylotomy/eminectomy, modified condylotomy, arthroplasty, and joint reconstruction using autogenous or alloplastic materials.

• #37 Temporomandibular Disorders: MedlinePlus

  https://medlineplus.gov/temporomandibulardisorders.html

  It’s important to be careful, because sometimes surgery or another procedure may not work or may even make your symptoms worse. Before any surgery or other procedure, it is very important to get opinions from more than one provider and to completely understand the risks. If possible, get an opinion from a surgeon who specializes in treating TMDs.

• #38 CE Activity | Temporomandibular Syndrome | Nurses

  https://www.statpearls.com/nurse/ce/activity/104299/?specialty=specialty

  Temporomandibular disorder (TMD) refers to a group of conditions involving the orofacial region divided into those affecting the masticatory muscles and those affecting the temporomandibular joint (TMJ). The typical features include pain in TMJ, restriction of mandibular movement, and TMJ sounds. These symptoms may resolve by themselves without further treatment. If not, conservative methods are the first to be used with positive results in most patients. This activity reviews the evaluation and treatment of temporomandibular disorder and highlights the role of the interprofessional team in evaluating and treating patients with this condition. […] This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, nurse practitioners, and dentists.

• #39 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  While medical history taking is part of most practitioners’ training, taking a pain history may not be, and a psychosocial history is quite often outside a practitioner’s skills, or it may be set aside due to time constraints. […] The current standard for an examination pertinent to TMDs includes specific tests of the masticatory system and, when indicated, TMJ imaging. […] The treatments in this section are organized by type of intervention as follows: (1) psychological/behavioral/self-management, (2) physical, (3) complementary, (4) pharmacological, and (5) interventional. […] It is important to note that most current TMD treatments lack strong evidence to support or reject their use. […] In considering the appropriate role for evidence in making treatment decisions, strong evidence supporting the use of a particular type of treatment and strong evidence against the use of a particular type of treatment should be regarded as a starting point in choosing treatments in the spirit of the requirement to do no harm.

• #40 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  The establishment of professional societies, such as the American Academy of Orofacial Pain, has helped to advance greater understanding and adoption of the role of scientific evidence in making clinical decisions by dentists and physical therapists who treat TMDs. […] This leaves well-meaning providers without reliable treatment strategies. […] Cautious and collaborative management is the rule. […] The cornerstone of the progressive management of disease is prevention. […] With so little known about the causes and development of TMDs, primary prevention strategies have focused mainly on behaviors such as eating soft food and avoiding items like apples or large sandwiches that require excessive jaw opening. […] Another prevention strategy is early recognition and management of the biological and psychosocial contributors to TMDs, including comorbid medical conditions such as juvenile idiopathic arthritis and other rheumatologic diseases.

• #41 Understanding Temporomandibular Disorders (TMD)

  https://www.veteranshealthlibrary.va.gov/3,89757

  Understanding Temporomandibular Disorders (TMD) […] Do you have pain in your face, jaw, or teeth? Do you have trouble chewing? Does your jaw make clicking or popping noises? These symptoms can be caused by temporomandibular disorders (TMD). This is a group of problems related to the temporomandibular joint (TMJ) and nearby muscles. The TMJ is the joint that opens and closes your mouth. Your symptoms may be painful and frustrating. However, your health care team can help you treat TMD and prevent future problems. […] If you are having TMD symptoms, dont wait. Call your dentist or health care provider right away. You dont have to live with pain or discomfort. TMD can be treated. In fact, a key part of treatment is learning to manage your condition at home. […] Treatment helps rest the muscles and joint. It also helps relieve symptoms and restore function. Depending on the type of problem you have, your treatment plan may include: […] A mouth guard or bite plate. […] Dental treatment to reduce pressure on the joint. […] Treatment can help relieve your current condition. But TMD symptoms may return over time. You may prevent future problems by maintaining the health of your jaw: […] Follow your treatment plan. […] Pay attention to your body and get help if symptoms return.

• #42 Self-Care for Temporomandibular Disorders (TMD) | UMass Memorial Health

  https://www.ummhealth.org/health-library/self-care-for-temporomandibular-disorders-tmd

  You have TMD. This term describes a group of problems related to the TMJ and nearby muscles. Treatment will get your jaw back to normal function. But your care doesn’t end there. Once you’ve had TMD, it’s important to prevent reinjury. Get in the habit of doing self-checks. […] You have temporomandibular disorder (TMD). This term describes a group of problems related to the temporomandibular joint (TMJ) and nearby muscles. The TMJ is located where the upper and lower jaws meet. Treatment will get your jaw back to normal function. But your care doesnt end there. Once youve had TMD, its important to prevent reinjury. Get in the habit of doing self-checks. This can make you aware of any symptoms that begin to return, so you can take action right away. […] If you answer yes to any of the questions above, you need to take action. Changing your posture or taking a short break can help prevent or relieve TMD symptoms.

• #43 Self-Care for Temporomandibular Disorders (TMD)

  https://healthlibrary.wjmc.org/library/diseasesconditions/Adult/Women/3,89755

  You have temporomandibular disorder (TMD). This term describes a group of problems related to the temporomandibular joint (TMJ) and nearby muscles. The TMJ is located where the upper and lower jaws meet. Treatment will get your jaw back to normal function. But your care doesnt end there. Once youve had TMD, its important to prevent reinjury. Get in the habit of doing self-checks. This can make you aware of any symptoms that begin to return, so you can take action right away. […] Make it a habit to assess your body a few times each day. Try writing yourself a reminder. Or set an alarm on your watch or phone. When doing a self-check, ask yourself: Do I feel stressed? Are my muscles tense? Am I grinding or clenching my teeth? Is my posture healthy for my body? Is there anything I can do to make myself more comfortable?

• #44 Self-Care for Temporomandibular Disorders (TMD) | UMass Memorial Health

  https://www.ummhealth.org/health-library/self-care-for-temporomandibular-disorders-tmd

  Dont eat hard or chewy foods. Even if you feel fine, eating such foods can trigger symptoms again. […] Be aware of your body. Dont ignore TMD symptoms. The nagging pain in your neck or jaw may be a sign that you need care. […] Keep follow-up appointments. Be sure to keep all appointments with your healthcare team. […] Stress is a key factor in TMD. Stress can make you clench your muscles or grind your teeth. It can also affect your sleep, reducing your bodys ability to heal. […] Activity helps the body in many ways. You stay looser and more relaxed. It also helps keep muscles and tissues conditioned. That way you can heal faster and make reinjury less likely.

• #45 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  Despite the best intentions of many of these professionals to improve the lives of individuals with a TMD and the positive treatment outcomes that many individuals with TMDs have achieved, significant challenges have led to inappropriate treatment and life-altering harm for some individuals. […] Historically, patients suffering from a TMD have turned to dental and medical professionals for help, often to find little expertise available. Some are given non-evidence-based interventions, which can lead to a worsening of the disorder and unintended harm. […] Patients with chronic orofacial pain have said that it is important for health care professionals to be empathetic even when no effective treatments can be offered. […] Thanks to a combination of factors—patient advocacy groups such as The TMJ Association bringing concerns regarding harmful treatment to the forefront, the appearance of rigorous outcomes evaluation, honest results reporting by leaders in the TMD research community, and improvements in the basic science understanding of TMD—the field of TMD care has slowly become more evidence based; however, variations in care practices still exist.

• #46 Temporomandibular Disorders (TMD) From Research Discoveries to Clinical Treatment | National Academies

  https://www.nationalacademies.org/our-work/temporomandibular-disorders-tmd-from-research-discoveries-to-clinical-treatment

  Individuals with TMDs often feel stigmatized and invalidated in their experiences by their family, friends, and, often, the health care community. […] The recommendations of Temporomandibular Disorders focus on the actions that many organizations and agencies should take to improve TMD research and care and improve the overall health and well-being of individuals with a TMD. […] The ad hoc committee will identify approaches to advance basic, translational, and clinical research in the field. […] Identify barriers to appropriate patient-centered TMD care, in the presence and absence of an evidence base, and strategies to reduce these barriers along the continuum of TMD pain. […] Identify opportunities and challenges for development, dissemination, and clinical implementation of safe and effective clinical treatments for TMD, including pharmacological agents, regenerative medicine, behavioral interventions, and complementary and integrative approaches.

• #47 TMJ Disorders: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/15066-temporomandibular-disorders-tmd-overview

  TMJ specialists include: Oral surgeons. Orthodontists. Otolaryngologists. Prosthodontists (dentists specializing in dental prostheses and appliances). […] You cant always prevent TMD because some risk factors are unavoidable. But there are things you can do to reduce your risk: Wear a mouth guard at night if you clench or grind your teeth. […] TMJ dysfunction affects everyone differently. For some, its a temporary issue that goes away in a week or two. For others, its a chronic condition that negatively impacts quality of life. […] If you have frequent jaw pain, facial pain, headaches or other TMJ symptoms, tell a healthcare provider. They can help you find an effective treatment. […] Yes, its possible to cure TMJ dysfunction with appropriate treatment and management. […] If you have persistent TMJ pain, popping jaws or other symptoms, schedule a visit with a healthcare provider. They can help you find out why your jaws are aching and determine what kind of treatment you need. […] If you have jaw pain, headaches or other symptoms that keep you from enjoying life, talk to your healthcare provider. They can find the cause and recommend appropriate treatment.

• #48 TMJ disorders Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/tmj-disorders

  Temporomandibular joint and muscle disorders (TMJ disorders) are problems that affect the chewing muscles and joints that connect your lower jaw to your skull. […] You may need to see more than one medical specialist for your TMJ pain and symptoms. This may include a health care provider, a dentist, or an ear, nose, and throat (ENT) doctor, depending on your symptoms. […] Simple, gentle therapies are recommended first. […] Read as much as you can on how to treat TMJ disorders, as opinion varies widely. […] Ask your provider or dentist about medicines you can use. […] Mouth or bite guards, also called splints or appliances, have long been used to treat teeth grinding, clenching, and TMJ disorders. […] If conservative treatments do not work, it does not automatically mean you need more aggressive treatment.

• #49 Temporomandibular Joint Disorders (TMD) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/temporomandibular-joint-disorders-tmd

  Most children who have TMD eventually have normal jaw function after treatment. […] Here at Boston Children’s, we’ll customize our treatment for your child’s TMD based on his specific symptoms. That treatment can include everything from home care to surgery. […] Treatment depends on the severity of your child’s condition. It ranges from range-of-motion jaw exercises and medications to physical therapy, joint injections and/or surgery. […] If your child’s symptoms are mild, home care and anti-inflammatory medications can help. If the condition is more severe, physical therapy, dental treatments or joint surgery may be needed. […] At Boston Children’s, we consider you and your child integral parts of the care team. You and your care team—which can include pediatric dentists, otolaryngologists (ear, nose and throat doctors) and oral surgeons—will work together to customize a plan of care for your child.

• #50 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  A similar push toward the early diagnosis and management of other factors that cause or contribute to TMDs may decrease future morbidity. […] Prevention must not stop at the onset of a TMD. […] This secondary prevention approach requires close collaboration between the individual and his or her health care professional to avoid over-treatment, iatrogenic harm, or an aggravation of a TMD and to identify self-care or other interventions that may decrease the negative impact of the disorder on that individual. […] Following the publication of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a central concern was whether the DC/TMD in its present form is appropriate for clinical use. […] A clinical assessment for TMDs should include talking with the patient to hear the history of the symptoms and problems, an examination, special tests such as imaging when indicated, and psychosocial assessment.

• #51 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  This chapter discusses these challenges and describes the current state of prevention, detection, assessment, diagnosis, and treatment of TMDs. The final section of the chapter explores approaches for improving the evidence base for TMD treatments and patient care: conducting clinical trials, building a TMD patient registry, and developing clinical practice guidelines. Chapter 6 addresses other challenges to the caring for individuals with a TMD, including provider education, the medical-dental divide, the lack of access to specialty care, and payment and coverage issues. […] The multiple types of TMDs and the extensive comorbidities often seen in patients with TMDs have posed a challenge to clinicians for decades. Correct diagnosis is the first barrier, and it is complicated further by confusing terminology and a lack of clarity about the causes and development of the disorders.

• #52 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  Many patients here and around the world are lost, forgotten, and suffering. I cannot imagine that all of us here don’t share the hope that someday the approach to TMDs will be drastically different from what we have experienced, and continue to experience today. […] Historically, the care of some individuals with temporomandibular disorders (TMDs), especially those with chronic and painful TMDs, has been fraught with challenges and complications. The committee identified several stumbling blocks in the evolution of effective care for individuals with a TMD, including the rise of multiple competing theories among different groups regarding what causes TMDs and how best to treat individuals with TMDs; minimal high-quality evidence about which treatments are appropriate for which patients; patient abandonment by clinicians who have exhausted their treatment capabilities; and a clouding of the role of surgery in care of patients with TMDs by harmful devices such as Proplast/Teflon- or silastic-based TMJ implants in the 1970s and 1980s.

• #53 Temporomandibular Disorders: Priorities for Research and Care | The National Academies Press

  https://nap.nationalacademies.org/catalog/25652/temporomandibular-disorders-priorities-for-research-and-care

  Temporomandibular disorders (TMDs), are a set of more than 30 health disorders associated with both the temporomandibular joints and the muscles and tissues of the jaw. […] Everyday activities, including eating and talking, are often difficult for people with TMDs, and many of them suffer with severe chronic pain due to this condition. […] This report addresses the current state of knowledge regarding TMD research, education and training, safety and efficacy of clinical treatments of TMDs, and burden and costs associated with TMDs. […] The recommendations of Temporomandibular Disorders focus on the actions that many organizations and agencies should take to improve TMD research and care and improve the overall health and well-being of individuals with a TMD. […] Caring for Individuals with a TMD […] Improving TMD Health Care: Practice, Education, Access, and Coverage […] Improving Patient, Family, and Public Education and Awareness About TMDs.

• #54 Temporomandibular Disorder Treatment Guidelines | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/get-involved/nominated-topics/Temporomandibular-Disorder-Treatment-Guidelines

  Current treatment guidelines for temporomandibular disorders (TMDs) lack sufficient science-based evidence. This gap in evidence leads to multiple healthcare visits, sometimes contradictory advice to patients, and ineffective treatments, with sometimes harmful outcomes. Patients suffer continued oral and facial dysfunction, financial difficulties, social stigma, and an increasingly poor quality of life because guidelines for quality care are not available. […] A summary of the current research supporting comprehensive, interdisciplinary, clinical management of TMDs is needed in light of recent advancements in our understanding of the disease process, its many risk factors, and underlying etiology. A clinical practice guideline supported by high quality research is sorely needed. […] There is a need for clinical treatment guidelines for treating TMDs that are patient-centered, interdisciplinary, team oriented, and above all, based on high quality basic, translational, and clinical research results. Current guidelines do not meet these standards.

• #55 Caring for Individuals with a TMD – Temporomandibular Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557986/

  The recognition that some TMDs are systemic pain conditions with local manifestations around the TMJ, rather than a primarily orthopedic condition, has resulted in a shift away from surgery as a first-line treatment for most patients. […] Improvements in the understanding of joint physiology and in the diagnosis of TMD have supported these changes, bringing emphasis to holistic, patient-centered treatment and the avoidance of multiple and non-indicated invasive procedures. […] In the assessment of literature pertaining to treatments for individuals with TMDs, rarely can a small research study prove direct harm; rather, the outcome measure typically relates to treatment effectiveness. […] Chapter 6 discusses improvements needed in the health care management of individuals with TMDs including the proposal of centers of excellence for TMD care.

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