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• W2108460069 abstract "A stepwise method for treating TMPDS is presented. Step 1-start patient on a regimen of chloroethane or chlorofluorocarbon spray and exercise. Step 1A--if a clicking joint is the chief complaint, start with click exercise. Step 1B--if restricted mouth opening is the chief complaint, start with range of motion exercise; employ exercises sequentially, not simultaneously. Step 2--if pain is moderate to severe, start with amitriptyline 10 mg at bedtime, increasing the dose in 10-mg increments to 40 mg. Step 3--for nonresponders, add injections of tender points with lidocaine and consider a trial of a different tricyclic. Step 4--for nonresponders, consider a trial of tender point injections combining dexamethasone with local anesthetic. Start by injecting the three most painful tender points with 0.5 mL of a solution of 1 mg of dexamethasone combined with two thirds bupivacaine and one third lidocaine to reach the desired volume. Repeat injections, varying the sites as required. Do this once weekly for 4 to 6 weeks for an adequate trial. This regimen can be continued for an extended period of time with appropriate precautions in place. The value of judgment-free psychosocial support cannot be overemphasized. Patients with TMPDS are faced with long-term problems of pain management. An understanding clinician can provide the sustained support required to prevent the cycle of ever more invasive treatments with their potential for harm." @default.
• W2108460069 created "2016-06-24" @default.
• W2108460069 creator A5040243479 @default.
• W2108460069 date "1996-08-01" @default.
• W2108460069 modified "2023-10-14" @default.
• W2108460069 title "TEMPOROMANDIBULAR PAIN AND DYSFUNCTION SYNDROME" @default.
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• W2108460069 doi "https://doi.org/10.1016/s0889-857x(05)70283-0" @default.
• W2108460069 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/8844909" @default.
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