Temporomandibular disorder: Difference between revisions
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*Jaw pain | *Jaw pain | ||
*Popping/clicking of jaw | *Popping/clicking of jaw | ||
*Ear pain/popping | *[[Ear pain]]/popping | ||
*Headache | *[[Headache]] | ||
*intermittent locking of the jaw | *intermittent locking of the jaw | ||
| Line 14: | Line 14: | ||
==Evaluation== | ==Evaluation== | ||
* | *Clinical diagnosis | ||
*Research Diagnostic Criteria (RDC/TMD) is gold standard for diagnosis/research purposes | *Research Diagnostic Criteria (RDC/TMD) is gold standard for diagnosis/research purposes | ||
**Pain in muscles of mastication, the TMJ, or the periauricular area, usually worsened by manipulation or function | **Pain in muscles of mastication, the TMJ, or the periauricular area, usually worsened by manipulation or function | ||
| Line 21: | Line 20: | ||
**Limitation of mandibular movements | **Limitation of mandibular movements | ||
**Pain present for minimum of 3 months | **Pain present for minimum of 3 months | ||
*Consider imaging if history of trauma/facial trauma | |||
*Consider imaging if | |||
==Management== | ==Management== | ||
* | *Analgesia | ||
**NSAIDs are first line, consider | **[[NSAIDs]] are first line, consider [[opioids]] if not well controlled | ||
*Occlusal splints/bite blocks at night for bruxism | *Occlusal splints/bite blocks at night for bruxism | ||
| Line 33: | Line 31: | ||
==Disposition== | ==Disposition== | ||
*Discharge | *Discharge | ||
*Follow up with dentist/ | *Follow up with dentist/primary care provider | ||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:ENT]] | |||
Revision as of 02:30, 11 December 2016
Background
- TMJ refers to temporomandibular joint dysfunction, a symptom complex caused by pain/dysfunction of the muscles of mastication
- Associated with bruxism, degenerative joint disease, trauma, and anatomical issues of the TMJ joint
Clinical Features
Differential Diagnosis
Jaw Spasms
- Acute tetanus
- Akathisia
- Conversion disorder
- Drug toxicity (anticholinergic, phenytoin, valproate, carbamazepine)
- Dystonic reaction
- Electrolyte abnormality
- Hypocalcemic tetany
- Magnesium
- Mandible dislocation
- Meningitis
- Peritonsillar abscess
- Rabies
- Seizure
- Strychnine poisoning
- Stroke
- Temporomandibular disorder
- Torticollis
Evaluation
- Clinical diagnosis
- Research Diagnostic Criteria (RDC/TMD) is gold standard for diagnosis/research purposes
- Pain in muscles of mastication, the TMJ, or the periauricular area, usually worsened by manipulation or function
- Asymmetric mandibular movement with or without clicking
- Limitation of mandibular movements
- Pain present for minimum of 3 months
- Consider imaging if history of trauma/facial trauma
Management
- Analgesia
- Occlusal splints/bite blocks at night for bruxism
Disposition
- Discharge
- Follow up with dentist/primary care provider