The incidence of TMJ disorder is still quite high, but because of the “variety of symptoms, causes and treatments”, many patients do not know how to seek medical treatment. The most important thing is to use the simplest language to help people understand the disease, know what direction of treatment is available, and also find the most appropriate treatment for themselves. The mainstream treatments are the following: Surgery: For most patients, especially in the early stages, neither foreign consultation guidelines nor I personally recommend it, much less should it be the way to go without any conservative treatment, because the trauma of surgery can be worse than the original problem, the recurrence rate is high (especially with arthroscopic surgery), and when a recurrence occurs only another surgery can be performed. Surgery is only indicated when there is severe wear and tear on the joint, when there is significant facial deformity, when conservative treatment does not resolve the pain and limited mouth opening, and when the patient is clear about the risks and benefits. Joint cavity injections: No matter what is injected, an injection is an invasive treatment and is not considered conservative treatment. So small joint cavity, injected with a large amount of fluid, there is also a certain amount of damage to the joint capsule, but for the joint disc adhesions, or joint inflammatory mediators obvious patients, the effect is often very fast and obvious, we also need to know the risks and benefits, and decide for themselves. Hot compresses: This is the most mentioned by dentists, you can try, wet hot compresses with hot towels, no more than 10 minutes, do not overheat, so as not to burn, if there is no effect for two days, then there is no effect. Some people also use what moxa guilt, or other heat sources, anyway, pay attention not to burn, I have seen again outpatient seeking treatment for patients before the ear themselves burned. Acupuncture: Chinese medicine should have a different understanding of this disease than Western medicine, and can not make objective comments. Anyway, a treatment that does not have any effect for two weeks should be considered if it works for you. Rehabilitation treatment: Rehabilitation treatment is not as simple as just physical therapy and machines, but most of the rehabilitation departments in the region treat this disease by doing physical therapy with machines. For patients with “irreversible displacement”, there is still a very high chance of “manual repositioning” in the early two months, which means that there is a hope to completely restore the normal position of the joint disc, which also confirms that the earlier the treatment, the better the effect. Because the displacement has taken too long, the soft tissues such as the joint capsule have already adhered to the contracture. However, not every patient who comes in early can be repositioned, and not every patient who is “repositioned” can eventually maintain a normal disc position. In clinical practice, we do not pursue “repositioning” of the patient, it is best to “reposition” the patient (shorter treatment time, immediate relief of opening restriction and pain), for patients who cannot be repositioned manually, the treatment of the rehabilitation department is to help the patient’s joint adapt to the new position, eliminate For patients who cannot be repositioned by manipulation, the treatment of the rehabilitation department is to help the patient’s joint adapt to the new position, eliminate the pain, restore the degree of opening and function, and help the patient improve the symptoms. Therefore, we should not blindly pursue repositioning, but should be rational in our understanding of treatment modalities, and we should not simply think that “repositioning by manipulation is very simple and applicable to everyone” and “only joint disc repositioning is really good”. The rehabilitation treatment is not only limited to the temporomandibular joint, but there are many factors that contribute to the pathogenesis of this disease, including incorrect posture and psychological state, which the rehabilitation department tries its best to help patients to correct and regulate. Patients in the rehabilitation department should have the lowest recurrence rate because they are treated from the source of the disease. Many patients also have cervical spine problems, which is even one of the factors for the onset of the disease, and the rehabilitation department also deals with them together. Oral exercises: In fact, there are many kinds of oral exercises for all different types of patients, it is really recommended that you do not do it indiscriminately, the purpose of many exercises is very different, only to the professional hospital, in order to get the most suitable for their own treatment plan. Drugs: mainly two categories, one is the anti-inflammatory and analgesic class, no pain generally do not need to eat, some patients have bone wear (that is, wait for the third category) pain is obvious, or to eat a period of time. Another category is the nutritional cartilage, if there is no indication of bone wear, also do not need to eat. Jaw pad treatment: Jaw pad treatment is one of the most used methods in dentistry to deal with this disease, the efficacy is still certain, but because of the wide variety of jaw pads, individual differences between doctors are not consistent, the patient’s condition is complex and diverse, the effect is also different from person to person. However, I personally think that the treatment of this disease only treats the joints without changing the behavior and posture, and it really doesn’t necessarily go to the root. Orthodontic treatment: It is generally not used as the main modality for this disease, and orthodontics also recommends patients with displaced articular discs to treat the joint disease first. Extraction: Usually wisdom teeth, must also be recommended by a professional dentist, and it is clear that the pain and mouth opening restriction is due to wisdom teeth before deciding to extract or not to extract. Resting position: called by many patients as God’s position, but in fact it is a very simple and common position, which is the normal natural position where the upper and lower jaw teeth do not touch each other while sitting in a natural and relaxed position. This is something that we emphasize that every patient must master and adapt to. Patients who cannot learn the resting position, I think the efficacy is hard to say. At this time, the joint muscles are at rest, which helps them to recover. To sum up, the treatment for patients with “irreversible displacement” is not that difficult from the rehabilitation department, but “the longer the patient has had the disease, the lower the cooperation with treatment, the lack of understanding, the obsession with the need to reset, the lack of sufficient security for the future, the pursuit of perfection of the face, the charming melancholy temperament “However, the longer the patient has been suffering from the disease, the lower the cooperation with the treatment, the lack of understanding, the obsession with the need to reset, the lack of sufficient security for the future, the pursuit of perfection of the face and the charming melancholy temperament, it is difficult to say the real effect.
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