How is temporomandibular joint disorder treated?

  In our daily outpatient work, we encounter many patients with temporomandibular joint disorder. Patients are wandering between various treatment methods with concerns about the disease and doubts about the treatment. The following is a summary of some common patient questions: 1. Why did the surgeon say my joint needs surgery? Can I do without surgery?  For patients with an MRI diagnosis of “irreducible disc displacement”, surgery is usually recommended when they are seen by an oral surgeon. Surgery is also an effective treatment to restore the normal position of the disc. However, clinical observations show that the clinical presentation of the patient does not always correspond to the changes in the joint. Some patients with displaced articular discs have no temporomandibular joint-related discomfort at all; in the normal asymptomatic population, displacement of the articular disc is present in about 30% of the population. Current medical opinion is that the goal of treatment for temporomandibular disorders is to restore the function of the joint rather than to normalize the anatomy of the joint. For patients with displaced articular discs, conservative treatment can be considered first to improve symptoms, and then more invasive surgical treatment can be considered if conservative treatment is not satisfactory.  The treatment goal of temporomandibular joint disorder is not to restore the anatomical structure of the joint, but to restore the function of the joint. The currently accepted treatment goals at home and abroad are: (1) to reduce joint pain; (2) to improve mouth opening and joint function; (3) to reduce further damage to the joint and delay the progress of the disease; (4) to improve the quality of life.  3.Can I return to the “original” state after treatment?  Many patients ask, “Can conservative treatment restore the original/normal condition?” Objectively speaking, no one can go back to yesterday, that is, the person you are today is not the person you were yesterday. After the disease occurs, doctors hope that patients can have a positive attitude and face the disease in an optimistic and scientific way. In the clinic, it is true that some patients are able to restore their joints to normal through treatment, but not all of them can achieve such treatment results. Most of the patients can improve the symptoms of restricted mouth opening, skewed mouth opening and joint popping through treatment, and their daily life is not affected. At present, this is considered to be an effective treatment.  4.How long does conservative treatment take?  Depending on the patient’s condition and ability to receive treatment, the treatment time varies greatly. Some patients can have significant improvement in their symptoms after 2-3 treatments, while others may need 1-2 months of treatment or even longer. The overall pattern is that the longer the duration of the disease, the longer the treatment time required. The average treatment time is about 1-3 weeks.  5.Will there be a relapse after treatment?  After the treatment of the disease, most patients have achieved very good results. At this time, patients may worry about the recurrence of the disease. For each patient, pay attention to the protection of joints and have good personal habits, recurrence is less likely to happen.