<p>Temporomandibular disorders: improving outcomes using a multidisciplinary approach</p>

Abstract

Patients with temporomandibular disorders (TMD) can become very complex. This article aims to highlight the importance of the multimodal and multidisciplinary approach in this type of patients to improve clinical outcomes. At present we have innumerable techniques and tools to approach this type of patients from a biopsychosocial model where active and adaptive type treatments are fundamental. There are various health professions that have competence in the treatment of TMD, however, although in the most complex cases should be treated simultaneously, still too many patients receive unique treatments and only from one point of view. This review exposes the treatments available from a clinical-scientific perspective and also emphasizes the importance of working in specialized units with those professionals who have competencies on the different conditions that may occur.

Initial treatment for patients with temporomandibular disorders: pain relief and muscle tone relief by photobiomodulation therapy using carbon dioxide laser

“…Therefore, we started pharmacotherapy first with Amfenac sodium to avoid starting treatment in the acute phase. Sprinting treatment has been reported to be effective in preventing clenching and protecting teeth and temporomandibular joints; however, the effects are not constant according to the literature [1,2,8], and changes in occlusion such as open bite are feared [2]. Therefore, sprinting treatment was not administered as part of the initial treatment.…”

“…The main symptoms of temporomandibular disorder (TMD) are temporomandibular joint clicking, pain in the temporomandibular joint and muscles of mastication, mouth opening problems, and jaw movement abnormalities [1][2][3][4][5][6][7][8]. The causes of TMD are multifactorial, and anatomical abnormalities and associated functional, structural, and psychological factors have been identified [1][2][3][4][5][6][7][8].…”

“…The main symptoms of temporomandibular disorder (TMD) are temporomandibular joint clicking, pain in the temporomandibular joint and muscles of mastication, mouth opening problems, and jaw movement abnormalities [1][2][3][4][5][6][7][8]. The causes of TMD are multifactorial, and anatomical abnormalities and associated functional, structural, and psychological factors have been identified [1][2][3][4][5][6][7][8]. Conservative therapies in the early stages of treatment, rather than irreversible treatments such as aggressive surgery or occlusal adjustment, have recently been recommended in patients with TMD [1][2][3][4][5][6][7][8].…”

“…The causes of TMD are multifactorial, and anatomical abnormalities and associated functional, structural, and psychological factors have been identified [1][2][3][4][5][6][7][8]. Conservative therapies in the early stages of treatment, rather than irreversible treatments such as aggressive surgery or occlusal adjustment, have recently been recommended in patients with TMD [1][2][3][4][5][6][7][8]. These conservative therapies include pharmacotherapy and physical therapy; laser therapy is included within the broader category of physical therapy and is often administered in conjunction with muscle-stretching exercises [1,2,6,8,9].…”

“…Photobiomodulation therapy (PBMT) is a conservative type of therapy, and the irradiation delivered via PBMT is believed to have photobiomodulatory effects [3,6,10,12,19]. It reportedly has pain-relieving effects on conditions that involve chronic pain such as TMD and dentin hypersensitivity [1][2][3][10][11][12][13][14][15][16][17][18][19][20][21]. Semiconductor lasers [6,[10][11][12][13][14][15][16][17][18][19][20][21] and carbon dioxide (CO 2 ) lasers [22][23][24][25][26][27][28][29][30][31][32][33] have both been used to elicit such effects.…”