For patients with temporomandibular joint (TMJ) disorder, pain is the most common reason to seek professional help. Pain usually manifests itself as a constant, dull, frequently one-sided pain, radiating to the angle of the jaw, to the temple and to the ear (often to the whole jaw and to individual teeth), which escalates during chewing. These symptoms might be also accompanied by muscle tenderness during palpation and by the presence of trigger points.

Radiation of pain in TMJ disorders is often the cause of error in diagnosis. The most common error is to identify the cause of pain as coming from tooth, a migraine headache, as typical facial or headache pain, or as trigeminal neuralgia. Patients who suffer from pain in the area of the head while seeking help often are sent to different specialists: neurologists, ENT specialists, internists, or dentists. Incorrect diagnosis may lead to ineffective therapy, to merely symptomatic treatment, or worse, to the possibility of iatrogenic complications.

Treatment of functional disorders is a long-term process. The primary method of conservative treatment is the application of occlusal splints (splint therapy). The most commonly used are two types of splints: a muscle relaxation appliance, the main goal of which is to reduce muscle pain; and an anterior repositioning appliance also called an orthopedic repositioning appliance, which aims to change the position of the mandible in relation to the skull. The use of a splint helps to relieve patients from symptoms in about 60% of cases. Often a combination of therapies is performed, that is, the application of splints combined with physiotherapy, and in some cases, with pharmacotherapy. However, the condition of successful therapy is causal treatment aimed at eliminating the primary causal factors. That is why once splint treatment is completed, it is advisable to eliminate the occlusal-based cause in TMJ dysfunction. In most cases, it is necessary to conduct subsequent occlusal reconstruction for the proper alignment of the mandible in a new position.

Treatment of functional disorders of TMJ can be conducted only by specialized dentists, as setting the mandible in an incorrect position, an improper application of a splint, or an unskilled proceeding during and after treatment may not lead to any effect, but even worse, may dramatically worsen the patient’s condition.

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