what does TMD stand for
Temporal mandibular disorder
not dysfunction
although you can have dysfunction but that is a type
what different types of TMD are there
- muscles
- disc
- bones
- sub luxations/ luxations (ligaments)
where should the disc sit in the TMJ
just above the condyle
where does the disc most commonly displace to
anteriorly
what is it called when you hear a click
Disc displacement with reduction
it is going back where it should be
if when a patient is opening and the disc doesn’t move back, what happens
- the condyle can’t rotate fully and patient won’t be able to open fully.
- There won’t be clicking
- disc displacement without reduction
What is the purpose of ligaments
to prevent excessive movement of joints
what is a subluxation of the TMJ
if dislocation occurs and you can just put it back in place
what is a luxation of the TMJ
a true dislocation and you would need help with that
Why might the muscles related to the TMJ be affected
- clenching/grinding
- sports (repetitive head movements e.g. weight lifting)
when palpating MOM what are you looking for
familiar pain
how would you test the lateral pterygoid
Open mouth and push against their jaw to try and close (if sore could be a sign it is tender as is the only muscle which opens)
Red flag signs and symptoms
What advice to give to a patient with TMD
- Stress
- Relaxation therapies
- Smaller pieces of food
- Avoid chewing habits
- Chew on both sides
- Heat and cold
- Sleep
- Analgesics
- Massage
- Support when yawning
- Always keep teeth apart when not eating
- Try splints
If not responding to conservative tx who do you refer to
oral surgery, oral med, max fax
What is important when making a splint
needs to be full coverage or will get over-eruption
What types of splints are there
- soft splints
- 50/50 dual laminate
- hard splints
- michigan/bite raising appliance
whats the best splint to start with usually and why
soft splint as easier to tolerate
pros and cons of soft splint
pros: easier to tolerate
cons: can be worn through easily
what is a 50/50 dual laminate splint
soft at fitting surface; hard at biting surface
pros and cons of hard splints
pros: more durable, less likely to bite through
cons: harder to tolerate
