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Temporomandibular joint disorders

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Associated with pain, clicking, popping, locking of the jaw, headaches, earaches, malocclusions and other processes that can interfere with quality of life.

Pain and restricted movement of the jaw seen in 5-15% of patients.

A chronic disease resulting in joint pain, dysfunction, and interference with activities of daily living.

It occurs in about 7% of adolescents.

Relate to the ball and socket joints that connect the jaw to the skull.

Disorders related to overuse, repetitive trauma, wear and tear, infections, systemic disease such as rheumatoid arthritis and congenital processes.

More than 10 million individuals in the U.S. suffer with such a process.

In a dental survey the prevalence of the rate of jaw locking on a weekly basis was 2.4% in women and 1.2% of men and a combined six prevalence rate of weekly facial and or jaw of pain of 5.2% and 1.8%, respectively.

Temporomandibular dysfunction remains a recurrent or persistent condition in more than 50% of diagnosed cases at a five-year follow up.

In the U.S. occurs mostly in women of childbearing age.

Three main categories of disease: jaw muscle pain, internal derangement and arthritis.

Headaches described as dull, deep and constant aches.

May have band like tightening on the sides of the head or along the front or back of the head.

Headaches may occur more often in the morning or vary in intensity throughout the day.

Morning headaches may be secondary to night time clenching or grinding of the teeth and also be associated with sleep disorders.

Pain may be increased during the day as a result of gravity on the neck and head posture.

Pain may be present in the sides of the lower jaw, or pain in the cheek or eye areas may be related to musculoskeletal pain.

In patients with missing back teeth a reduction of the height of the bite can create muscle trigger points, muscle fatigue and pain.

May cause pain in the eyes

Associated with chronic fatigue syndrome, sleep disorders, fibromyalgia and migraines.

OPPERA study is a 3-year prospective pilot study of 200 healthy women without TMD joint disease demonstrated that basal pain sensitivity, anxiety levels, and perceived stress are linked to the development of such processes (Diatchenko).

Otalgia occurs in greater than 70% of patients with temporomandibular joint dysfunction.

TMJ otalgia is severe with eating or passive movements of the mandible.

TMJ otalgia is due to muscle spasms involving muscles of mastication or intrinsic joint disease.

Associated factors include bruxism, clenching of the teeth, stress, dental malocclusion, and history of maxillofacial trauma.

Ear pain, dizziness, tinnitus, aural fullness, and perceived loss of hearing may occur.

Initial management includes an analgesic, such as an oral or topical nonsteroidal anti-inflammatory drug and an occlusal splint.

Occlusal splint modification is not supported by systemic review of prospective studies.

Intraarticular dextrose injection, known as prolotherapy therapy, result in substantial improvement in pain, function and maximal interincisal openings.

Surgical management is used as an exception.

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