dental disorders
Temporomandibular Myofascial Pain Syndrome
Treatment of Temporomandibular Myofascial Pain Syndrome
Mild analgesics Oral appliances Possibly temporary use of an anxiolytic orcyclobenzaprineat bedtime Trigger point injections and other physical and behavioral therapy modalities An oral appliance from a dentist can keep teeth from contacting each other and thereby reduce the damage caused by Bruxism . Over-the-counter heat-moldable (boil and bite) mouth guards are available from many sporting goods stores or drugstores; however, these types of devices should be used briefly and only as short-term diagnostic tools. Because these mouth guards may cause unwanted tooth movement or create a paradoxical increase in muscle activity, oral appliances should ideally be fabricated, fitted, and adjusted by a dentist. may facilitate muscle relaxation. However, in patients with Obstructive Sleep Apnea (OSA) , such as sleep apnea, anxiolytics and muscle relaxants should be used with caution because they can aggravate these conditions. Mild analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or The patient must learn to stop parafunctional behavior (eg, clenching the jaw, grinding the teeth) when awake. Hard-to-chew foods and chewing gum should be avoided. Physical therapy, biofeedback to encourage relaxation, and counseling help some patients. Physical modalities include trigger point injections, Electrical stimulation (TENS), and “spray and stretch,” in which the jaw is stretched open after the skin over the painful area has been chilled with ice or sprayed with a skin refrigerant, such as Most patients, even if untreated, customarily have diminished or cessation of significant symptoms within 6 to 12 months. 