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Oral and Maxillofacial Surgeon
The treatment for temporomandibular joint disorder comes with
1. assessing what kind of disorder it is (there are many types)
2. assessing what caused it
3. Assessing what aggravates it, or makes it flare up
4. treating the acute condition (pain, opening limitation, swelling etc), and
5. treating some of the long term consequences of the disorder (like developing osteoarthrits)
There are many different reasons or cause for a jaw joint disorder. Saying that you have “temporomandibular joint disorder” is like Latin for “you have a jaw joint problem”. It isn't a real diagnosis.
You wouldn't call a twisted knee as “tibia-fibula joint disorder”. You would instead apply a precise diagnosis like “ruptured anterior cruciate ligament with posterior instability in standing”.
Occlusion and jaw joints is like feet and knees. There are many types of knee problems ranging from osteo-arthritis, to muscle problems, to cartilage tears, and capsular strains and sprains.
Likewise jaw joints also have a range of disease types, which collectively fall under the term of “TMJ disorder”. Sure the teeth and bite are a major influence on how jaw joints work, but jaw joint disease requires careful assessment before any tretament can be applied, and that is usually through an oral and maxillofacial surgical specialist.
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Dentist
Diagnosis by a health professional is essential. A conservative treatment programme for those who are having acute pain of the jaw joint and muscles used in chewing can help if done over a 2 week period.
Rest: Soft Diet, avoid chewy sticky and tough foods, cut food into small pieces. Avoid Gum and lollies. Avoid opening the mouth too wide and limit speaking for long periods (its only for two weeks). Avoid clenching your teeth, make a conscious effort to separate your upper teeth from the lower teeth during the day.
Anit-inflammatory medication: This can help but only under the care and recommendation of a qualified health professional.
Moist mild heat pack : Use for 20 minutes 3x per day.
Nightgaurd: A properly made nightguard made by a dentist, will aid in stopping or minimising night time grinding so the muscles can relax.
Physiotherapy: Seek out a Physiotherapist that has a focus on head and neck physiotherapy. They can use other treatments such as manipulation, exercise, ultrasound, Tens etc.
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Bowen Therapist, Massage Therapist
Bowen Therapists offer hands on therapy that compliments the care of dentists.
Gentle cross fibre “Bowen” moves are applied at specific locations on the head and neck which stimulate the nervous system and promote connective tissue release.
You should notice a reduction of pain immediately after 1 treatment.
However, as with any Bowen treatment, each person's response is different and Bowen therapists usually recommend a series of treatments approximately 1 week apart. Personally I usually recommend approximately 3 treatments.
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Ear Nose and Throat (ENT) Surgeon
TMJ pain can be severe and quite disabling. Excluding ear or sinus conditions as a possible cause of the pain in a referred pain type setting is important. An ENT surgeon is best qualifiednfor this.
Given it is commonly an acute inflammatory condition, the usual approach to such “injuries” applies. The keys are to avoid trauma, reduce inflammation and remove reversible factors. Avoiding trauma is 2 weeks of a liquid diet, minimise talking/yawning and a detal review to look for teeth grinding signs. Infmallamtion is managed by anti-inflammatory medication best prescribed by a doctor. If this fails to adequately alleviate the pain, I then recommend a trial of a simple injection of steroids and local anaesthetic into the joint. It is unusual for patients to not gain benefit from this approach.
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