TMD Flashcards
name 2 systems that clarify orofacial pain
ICHD3 & ICOP
what do TMDs affect?
TMJ and/or muscles of mastication
how do TMDs present?
dull aching pain
affects ear, jaw and in front of temple
pain affected by jaw movement, function and parafunction
pain worse on clenching, wide opening and eating crunchy food
clicking, popping, snapping, crepitus in last 30 days
restricted opening, interefring w/ eating, locking
associated w/ clenching, grinding, chewing habits, musical instruments & singing
past hx of trauma
how do you examine the TMJ?
palpate lateral TMJ pole get pt to do the following 3 times:
open
close
lateral
protrusive
assess for any pain, noises
how do you examine the masticatory muscles - temporalis and masseter?
palpate muscles w/ teeth clenched
for masseter do bimanual palpation - finger on either side of the cheek
what is normal mouth opening (mm)?
> =40mm
list intraoral signs of TMD
ridging of buccal mucosa at level of occlusal plane
scalloping of borders of tongue
tooth wear
what radiographs are indicated for TMD investigation?
CBCT & MRI - not plain radiographs
give 2 groups of TMD
pain related & intra articular
name 2 types of pain related TMDs
myalgia - local myalgia, myofascial pain w/ or w/o referral
arthralgia - headache related to TMD
name 4 types of intrarticular TMDs
DD w/ reduction
DD without reduction
degenerative joint disease
subluxation
myofascial pain
pain from masseter or temporalis when palpate them on max opening
arthrlagia
pain on palpation of TMJ pole on max opening, excursions and protrusion
DD w/ reduction
disc anterior to condyle when at rest - clicks back over condyle on opening
clicking/popping/snapping
DD w/o reduction
limited opening - as disc does not reduce over condyle
closed lock
max assisted opening <40mm including incisal vertical overlap
degenerative joint diseases
articular tissue degenerated and osseous changes in condyle and/or articular eminence
crepitus
subluxation (open lock)
hypermobility disorder involving disc/condyle complex and AE
disc/condyle complex anterior to AE and unable to return to normal position without manipulation
jaw catches/locks in wide opening - for a moment or prolonged duration
pt could not close from wide open without manipulation
explain difference between subluxation and luxation
subluxation - pt manipulates jaw back into place
luxation - clinician required to manipulate jaw back into place
what medication should be used for TMDs? what should be used if there’s a muscle spasm or DD w/o reduction?
14 day course of ibuprofen (paracetamol as alternative)
if muscle spasm or DD w/o reduction then use diazepam for 5 day course
