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Temporomandibular disorders

from Chief complaints and diagnoses

Published online by Cambridge University Press:  18 December 2009

By
Nathanael Wood  and
John H. Burton
Edited by
Stephen H. Thomas
Stephen H. Thomas
Affiliation:
Harvard Medical School
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Summary

Tricyclic antidepressants (TCAs), NSAIDs, anxiolytic agents, and muscle relaxants are the most common agents used to treat temporomandibular disorder (TMD). Although low-dose TCAs have been studied for the treatment of various chronic pain states, the literature addressing their use in TMD is sparse. Benzodiazepines are commonly used for TMD, particularly when symptoms are thought to include a muscular component. Available evidence suggests a role for this drug class, but supporting data are not definitive. A recent study found no difference between patients treated with ibuprofen (400 mg PO TID) and those receiving glucosamine sulfate. The role of opioids in the treatment of TMD remains controversial. Two small placebo-controlled RCTs of low-dose amitriptyline demonstrated reduced symptoms in patients with chronic TMD and facial pain. Muscle relaxants, such as cyclobenzaprine or metaxalone, are occasionally used in TMD with a significant myofacial component.

Keywords

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Type
Chapter
Information
Emergency Department Analgesia
An Evidence-Based Guide
 , pp. 380 - 383
Publisher: Cambridge University Press
Print publication year: 2008

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