Temporomandibular disorder: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
ClaireLewis (talk | contribs) No edit summary |
||
| (7 intermediate revisions by 3 users not shown) | |||
| Line 6: | Line 6: | ||
*Jaw pain | *Jaw pain | ||
*Popping/clicking of jaw | *Popping/clicking of jaw | ||
*[[Ear pain]]/popping | *[[Earache|Ear pain]]/popping | ||
*[[Headache]] | *[[Headache]] | ||
* | *Intermittent locking of the jaw | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 22: | Line 22: | ||
*Consider imaging if history of trauma/facial trauma | *Consider imaging if history of trauma/facial trauma | ||
==Management== | ==Management<ref>Tsai V et al. Temporomandibular Joint Syndrome Treatment & Management. Jan 2018. https://emedicine.medscape.com/article/809598-treatment.</ref>== | ||
*Analgesia | *[[Analgesia]] | ||
**[[NSAIDs]] are first line, consider [[opioids]] if not well controlled | **[[NSAIDs]] are first line, consider very short term [[opioids]] if not well controlled | ||
*Muscle relaxers | |||
*Soft-food diet during acute episodes | |||
*Moist heat, massage of masticatory muscles | |||
*Occlusal splints/bite blocks at night for bruxism | *Occlusal splints/bite blocks at night for bruxism | ||
| Line 32: | Line 35: | ||
*Discharge | *Discharge | ||
*Follow up with dentist/primary care provider | *Follow up with dentist/primary care provider | ||
*50% of patients have improvement in 1 year, 85% in 3 years<ref>Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. Cranio. 2003; 21(1):68-76.</ref> | |||
==See Also== | ==See Also== | ||
Revision as of 17:46, 24 September 2019
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[1]
- Analgesia
- Muscle relaxers
- Soft-food diet during acute episodes
- Moist heat, massage of masticatory muscles
- Occlusal splints/bite blocks at night for bruxism
Disposition
- Discharge
- Follow up with dentist/primary care provider
- 50% of patients have improvement in 1 year, 85% in 3 years[2]
See Also
External Links
References
- ↑ Tsai V et al. Temporomandibular Joint Syndrome Treatment & Management. Jan 2018. https://emedicine.medscape.com/article/809598-treatment.
- ↑ Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. Cranio. 2003; 21(1):68-76.