Your Paragraph Text PDF
Your Paragraph Text PDF
Your Paragraph Text PDF
TEMPOROMANDIBULAR
DISORDERS (TMDs)
5th stage
There appears to be two ways the occlusal relationship of the teeth may be
associated with TMD symptoms. The first is related to an acute change in the
occlusal condition, for example: a situation when a crown or filling is placed and it
is left a little high; afterward, the patient reports back to the clinic complaining of
discomfort. Frequently this discomfort is not only around the sore tooth, but
there also is muscle tightness and pain because the muscles protectively co-
contract to minimize any damage Muscle co-contraction refers to the
simultaneous activation of muscles on opposite sides of a joint to maintain joint
stability.
Occlusal Condition
-In the last 30 days, how long did any pain last in your jaw or temple area on
either side?
a. No pain
b. Pain comes and goes
c. Pain is always present
-In the last 30 days, have you had pain or stiffness in your jaw on awakening?
a. No
b. Yes
TMD Screen History
-In the last 30 days, did the following activities change any pain (that is, make it
better or make it worse) in your jaw or temple area or either side?
Patients with TMD signs and symptoms may be seen and managed at three
stages:
1- TMD signs and symptoms may be present before the onset of orthodontic
treatment.
The orthodontist must be prepared to deal with each type of those patients.
Management of TMD signs and symptoms within an orthodontic practice.
At time of presentation
1. If patient has signs and symptoms of TMD, then the patient should be
informed that orthodontic treatment will not resolve those problems
2. Current TMD signs and symptoms should be noted, and a full TMD history
and clinical examination should be undertaken and recorded
During treatment 1. Acknowledge and recognize the signs and symptoms of TMD
2. Reassure and educate the patient that TMD is not necessarily a progressive
problem and in most cases symptoms will improve over time with conservative
treatment 3. Active orthodontic treatment should be discontinued, and TMD
signs and symptoms should be managed by either the orthodontist or an expert
TMD colleague 4. Once signs and symptoms have been alleviated or controlled,
active orthodontic treatment may be resumed with consideration to
modification of treatment (reduction of forces on headgear, remove or lighten
elastics, use of oral TMD treatment appliance)
Management of TMD signs and symptoms within an orthodontic practice.
After treatment
The patient should be monitored for signs and symptoms throughout the
retention period. If symptoms arise, appropriate management should be
provided