TMD

Question 1

Causes of TMD

Answer 1

1. Myofascial pain
2. Degenerative disease - osteoarthritis/ RA
3. Chronic recurrent dislocation
4. Ankylosis
5. Hyperplasia
6. Neoplasia
7. Infection

Question 2

Assessment checks for TMD

Answer 2

MOM check - hypertrophy
Mouth opening
Linea alba/wear

Question 3

What does crepitus indicate

Answer 3

Late degenerative change - crunchy sound

Question 4

Differential diagnosis for TMD

Answer 4

Dental pain
Sinusitis
Ear pathology
Salivary gland pathology
Atypical facial pain
Trigeminal neuralgia
Condylar fracture
Angina

Question 5

Second line tx for TMD

Answer 5

Botox - paralyse masseter
Steroids - injected into joint to reduce inflammation

Question 6

Advice for TMD

Answer 6

Soft diet
Chew bilaterally
Avoid chewing gum
Don’t incise food
Cut into small pieces
Supportive yawning
Stop parafunctional habits: nail biting/grinding
Pain relief

Question 7

Irreversible surgery options for TMD

Answer 7

Disc repair
Arthroscopy
High condylar shave
Total joint replacement

Question 8

Define anterior disc displacement with reduction

Answer 8

Condyle + disc translate past eminence

Condyle goes back first
Disc does slip back too

Question 9

Define anterior disc displacement without reduction

Answer 9

Condyle + disc translate past eminence

Disc doesn’t reduce back
Stays past eminence