1. Muscle Contracture Muscle contractures are abnormal reductions in the extensibility of the jaw muscles (usually the closers). Contractures can result from a trauma induced scar, a spontaneous slowly developing shortening of the muscles without enlargement, or a...
1. NSAIDs The orofacial pain conditions for which NSAIDs are prescribed include acute arthralgia (capsulitis), arthritis, and painful locked TMJ. Although there are many options, and the clinician has to select which best suits each patient, three NSAIDs are...
What are salivary stones? Salivary stones, also called sialoliths, are calcified organic masses that form within the salivary gland's secretory system. Salivary stones comprise of organic and inorganic materials, including calcium carbonates and phosphates, cellular...
Lidocaine Trigger Point Injections When myofascial pain is a component of the pain problem, a trigger point injection is helpful in treatment, but only after the patient demonstrates ability and compliance with the home stretching protocol. These injections are used...
Occlusal Appliances Occlusal guards have several purposes. The guards can protect the teeth from wear such as attrition, interrupt oral habits such as clenching, redistribute forces of sore and sensitized teeth, and establish a comfortable occlusal position in a...
Open Locking TMJ Manipulation This procedure is done to reduce open locking or open dislocation of the TMJ, and it can be done in one of two ways. One method includes grasping the jaw with both hands and placing the molars on the posterior molar teeth and the fingers...
The Myalgia or Myofascial pain protocol (MFP) is a self-directed home-based (and sometimes office-based) treatment approach, which includes several elements such as identifying and avoiding activities that are potentially harmful to the jaw system, increasing local...
Preventive and avoidance-based treatments to combat or resolve temporomandibular disorders are essential to relieving chronic pain. These procedures can be administered based on the circumstances or levels of pain. Self-limiting disease or non-progressive pain is an...
In this article we'll explore three primary tests to help diagnose temporomandibular disorders: Imaging testsPhysical medicine testsSerologic tests 1. Imaging Tests A. Panoramic Radiographs A panoramic radiograph is utilized primarily to have a general vision of the...
Arthralgia or Capsulitis Arthralgia/Capsulitis is defined as a painful joint (even without any osseous changes) with increased tenderness to palpation pressure. The clinical history and examination evidence needed for this diagnosis includes: A unilateral or bilateral...
Internal Derangement is not a diagnosis but a category of conditions and it simply means abnormal function of the intra-articular structures. It is a non-specific term applied as a descriptive subdivision term for the group of non-arthritic TM joint disorders (e.g.,...
Localized Myalgia Localized myalgia is a term used to describe a dull aching continuous which the patient localizes to muscles in the masticatory system (usually the masseter and temporalis) or cervical muscles (SCM and trapezius). If the myalgia is in...
There are four primary elements that form the theoretical basis for an occlusal stabilization appliance: It protects teeth from wear It stabilizes an unstable bite It makes the patient more aware of any oral habit It allows you to reduce loading on a specific...
What is a laser? Lasers are an intense, high energy, coherent (travels in a constant phase in time and space), monochromatic (a single wavelength particular to the medium), and collimated (travels in the same direction) electromagnetic radiation that is produced by a...
Oral Cryotherapy Oral cryotherapy is a very safe, easy to perform, and relatively inexpensive treatment for various selected oral lesions. You should never perform cryotherapy unless you know the diagnosis of the lesion you to freeze. HPV is associated with papillary...
What is a jaw bone biopsy? When you use the term “bone biopsy,” this could mean you are taking a piece of bone or you are taking tissue that resides inside a bone. There are two approaches for a bone biopsy. A closed/needle bone biopsy involves inserting a needle...
Minor Salivary Gland (MSG) Biopsy Minor salivary gland (MSG) biopsy of the lower lip mucosa is used to confirm the diagnosis of Sjogren’s syndrome. Sjogren’s is a chronic autoimmune disorder involving the destruction of glandular tissue. Sjögren's syndrome can cause...
What is a punch biopsy? An oral cavity punch biopsy is considered the primary technique to obtain diagnostic, full thickness skin specimens. It is performed using a circular blade or trephine attached to a pencil-like handle. The instrument is rotated down through...
A biopsy is defined as the sampling or removal of tissues or liquids from the body for examination, in order to determine the existence or cause of a disease. A biopsy is strongly recommended for most of the lesions that persist for more than two weeks which...
What is a trigger point? A trigger point is due to sensitized sensory nerves within a taut band of a muscle that when squeezed generates local and referred pain. The cause of a taut band is a hyperactive motor nerve branch, which generates sustained contraction in the...
This test is utilized when you have a focal, intraoral, probable neuropathic pain disorder involving a branch of the trigeminal nerve with palpable gingival allodynia/hyperalgesia and no obvious, local dental pathology exists such as tooth fractures, periapical...
TMJ injections are performed with corticosteroid and anesthetic to produce a two-fold effect: one reduce inflammation with the corticosteroid (triamcinolone acetonide) and two produce anesthesia or pain relief using lidocaine 2% without epinephrine. Corticosteriod is...
In this article, we review ways to assess muscle tenderness and pain. Common abnormalities of the masticatory muscle include injection induced myositis, myofascial taut band, trigger point, hypertrophy, spasms, etc. Note: Prior to each procedure, introduce yourself...
The following equipment is required for a Cranial Nerve Examination: Cotton ball Safety pin Pen torch (source of light) Tongue blade Tuning fork (512 Hz) 1.) Olfactory Nerve (I) The olfactory is a sensory nerve, and damage in the nasal epithelium or the basal...
