A
Temporomandibular joint disease (TMJ) and resultant dysfunction results
in significant pain and impairement for many. There have been multi-factorial
approaches gleaned out of thousands of clinical studies. These have been based
mostly on empirical evidence. Attempts in the last decade to suggest surgical
treatment modalities based on
MRI and
CAT scan parameters now receive
less attention. These techniques are reserved for the most recalcitrant cases
where other therapeutic modalities have changed. Exercise protocols and habit
control have in my experience of 35 years in oral surgery appear to be the
first line of approach. Certainly a focus on other possible causes of facial
pain and jaw immobility and dysfunction should be the initial consideration of
the examining oral surgeon or well-trained health professional. I suggest,
before the attending doctor commences any plan of approach utilizing
medications or surgery a thorough search for inciting para-functional jaw
habits must be performed. Correction of any discrepancies from normal can be
then be the primary goal.
/Talk