Abstract
An overview of current management concepts for temporomandibular disorders (TMD) is offered in this paper. Since TMD is supposed to be a self-limiting disease, reversible and less invasive management strategies must be selected initially. Mechanisms of joint pain and jaw dysfunction are based on inflammatory reactions and muscular stiffness. Therefore, control of inflammation and pain with medication especially in the initial phase of TMD is important. TMD is thought to be a multifactored disease. Since a background of joint inflammation and/or muscular stiffness must be overloading to the jaw based on various predisposing factors including behavioral factors, the treatment therapy should include not only occlusal appliances (stabilization splints) but also patient education and orientation for behavior modification and relaxation programs that would be very worthwhile. After control of the initial inflammatory phase with medication, etc., physical stretching, manipulation, joint pumping or arthrocentesis for an increase in range of motion would be effective. The temporomandibular joint has excellent adaptation ability, which is activated by jaw movement. To accelerate joint adaptation ability, physical therapy has an important role in TMD management. Control or reduction of contributory or predisposing factors is mandatory even after reduction of the symptoms and should be continued throughout one's lifetime, as a daily routine. In compromised cases psychological management should be considered. Individuals without pain in clicking or with asymptomatic radiological abnormality but who have abnormal habits are not targets of treatment, but education for behavior modification would be advisable.
