GENERAL CONSIDERATIONS IN THE TREATMENT OF TEMPOROMANDIBULAR DISORDERS Flashcards
What are the two categories of TMD treatments?
- definitive treatments
- supportive therapy
What are definitive treatments?
- directed to controlling or eliminating the etiologic factors that created the disorder
What are supportive therapys?
- treatment methods directed toward altering patient symptoms but often do not affect the etiology
What are common events that cause TMD?
local trauma or increased emotional stress
What is the second influencing effect of occlusion?
orthopedic instability
What are some etiologies of TMD?
- local trauma
- increased emotional stress
- orthopedic instability
- parafunctional activity
- diurnal or noctural
- bruxing or clenching
All initial treatments for TMD should be…
conservative, reversible, and noninvasive
What is occlusal therapy?
any treatment that is directed towards alterning the mandibular position and/or occlusal contact pattern of the teeth
What is the best type of reversible occlusal therapy?
occlusal appliance
What do occlusal appliances provide?
orthopedic stability
What is reversible occlusal therapy?
alters the patient’s occlusal condition only temporarily and is best accomplished with an occlusal appliance
What is irreversible occlusal therapy?
permanently alters the occlusal condition and/or manidbular position
What are examples of irreversible occlusal therapy?
selective grinding or restorative procedures
When a patient responds successfully to reversible occlusal therapy, these appear to be indications that ____________
__________ __________ may also be helpful.
irreversible occlusal therapy
Increased levels of emotional stress can affect…
muscle function by increasing the resting activity and/or increasing bruxism
What are the types of emotional stress therapy?
- refer them to a trained therapist
- educate the patient regarding the relationship between emotional stress, muscle hyperactivity, and the problem
What should you tell a patient to change if they have TMD?
- diet (eat softer food)
- do not bite on objects
- do not chew ice
- no heavy chewing
What are the two types of relaxation therapy?
substitutive
active relaxation
What is substitutive relaxation therapy?
- a substitution for stressful events or an interposition between them (activities they enjoy, exercise)
What is active relaxation therapy?
- therapy that directly reduces muscle activity (relax symptomatic muscles, biofeedback, negative biofeedback)
An effective way to start a stress reduction therapy is to establish a _______________
positive doctor-patient relationship
What should you present as a factor for TMD treatment early in the treatment plan?
stress and the relationship between pain, emotional stress, and dental procedures
Should you use definitive treatment in the case of macrotrauma?
Nah, it would be of little use since the trauma is no longer present
Should you use definitive treatment in the case of microtrauma?
Yes, it is necessary to stop the trauma (develop orthopedic stability)
Patient education on TMD shoudl begin by informing them that the teeth should only contact during….
chewing, speaking, and swallowing
What is nocturnal bruxism?
influenced by factors such as emotional stress levels and sleep paterns
(sometimes can be reduced with occlusal appliance therapy)
What is supportive therapy?
directed towards altering the patients symptoms, often has no effect on the etiology of the disorder
- helpful to provide immediate relief of symptoms
What are the two types of supportive therapy?
- pharmacological treatment
- physical therapy
What is pharmacological therapy?
the most common classes of pharmacologic agents used for the managment of TMDs
What are the types of pharmacologic agents used in TMD?
- analgesics
- antiinflammatories
- muscle relaxants
- anxylotics
- antidepressants
- anticonvulsives
What is physical therapy?
group of supported activites that is instituted in conjuction with definitive treatment
What are the types of physical therapy for TMD?
- thermotherapy
- coolant therapy
- ultrasound therapy
- electrogalvanic therapy
- transcutaneous electrical nerve stimulation (TENS)
- manual techniques
- muscle conditioning
- assisted muscle stretching
- acupuncture
