Most people with TMD have relatively mild or periodic symptoms which may improve with simple therapy. Self-care practices, such as eating soft foods, applying ice or moist heat, and avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing) are helpful in easing symptoms. It is strongly recommended using the most conservative, reversible treatments possible. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth.The following are treaments often recommended to patients:
- Occlusal (Bite) Adjustment
- TMJ Implants
Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency. Trauma is the most common cause of TMJ ankylosis, followed by infection. Diagnosis of TMJ ankylosis is usually made by clinical examination and imaging studies. The management goal in TMJ ankylosis is to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis.
- Previous TMJ surgery
- Congenital deformities
- Gap arthroplasty
- Interpositional arthroplasty
- Joint reconstruction
Recurrent TMJ dislocation
Recurrent Dislocation of the mandible is uncommon, but is distressing and disabling and requires urgent treatment. Causes include trauma, hypermobile or deranged temporomandibular joints, and involuntary movement.The primary treatment of a dislocation is reduction by manual manipulation with or without sedation or general anaesthesia. Applying a downward force on the posterior teeth while pushing the mandible back over the articular eminence will return the mandible to its correct position.
Ideally, acute mandibular dislocation requires immediate effective reduction, which can usually be accomplished with a closed technique. Dislocations that persist for more than one month are classified as chronic, and although they may be effectively reduced by conservative means using traction devices, they often demand the use of adjunctive techniques, including manipulation under general anesthesia and/or surgical techniques.
Recurrent temporomandibular joint dislocation requires preventive treatment. Current non-invasive techniques include injection of sclerosant or autologous blood around the temporomandibular joint to create fibrosis and limit jaw movement,a botulinum toxinA injection into the lateral pterygoid muscles or surgery like eminectomy.