oral med - TMD and RAU Flashcards
signs and symptoms of TMD
- headaches
- ear pain
- painful jaw
- clicking/ popping/ grinding sounds from jaw
- limited opening
- locked jaw
possible causes of TMD
parafunctional habits - clenching, grinding
stress - occupation, hobbies, family life
trauma
arthritis
describe TMD to a patient and potential causes
condition affecting temperomandibular joint which is joint connecting lower jaw to skull
Often due to muscular pain affecting muscles around the jaw but possible other causes such as problems within joint itself or arthritis
management of TMD
1 - patient education - reassurance, counselling, self management (soft diet, no gum, limit wide opening)
2 - splints - hard or soft
3 - pharmacological management - NSAIDs, tricyclic antidepressants
4 - surgery - rare
things to include in examination of possible TMD
- any restricted opening (<35mm)
- MOM - tenderness, hypertrophy
- clicking/ popping/ crepitus
- deviation
- IO signs of parafunction
what is RAU - tell patient
recurrent bouts of one or more painful ulcers in mouth. Common condition affecting up to 20% of population
3 different types - minor is most common
cause is unknown but genetic link - suggestions of allergy, hormones, viral infections
questions to ask in history of patient with suspected RAU
- painful?
- blister first?
- other mucous membranes affected?
- always same area)
- trauma?
- how long?
- recurrent
3 types of RAU
minor (80% of cases) - 1-6 ulcers at a time, <10mm, NK mucosa, about a week
major - 1-3 at a time, >10mm, any site, >30 days
herpetiform - <2mm but coalesce, NK mucosa, 1-2 weeks
symptoms of RAU
- painful ulcers
- recurring ulcers
further investigations for RAU
FBC and haematinic screen
coeliac screen
allergy testing
biopsy
treatment of RAU
1 - simple mouthwash (salty water)
2 - antimicrobial MW - CHX 0.2%
3 - local analgesics - benzydamine MW or spray
4 - topical corticosteroids - MDI or rinse
ALso refer for FBC, haematinic screen and coeliac screen
10 causes of ulceration
RAU
trauma
idiopathic
neoplastic
crohns
anaemia
mucositis
viral infections (PHG)
vesiculobullous diseases
behcets
