From the Guidelines
A 63-year-old male with dentures can still experience TMJ issues from teeth grinding, and management should prioritize conservative approaches. The most recent guideline for the management of temporomandibular disorders (TMD) recommends conservative approaches as the first line of treatment, including reassurance and education, avoidance of wide mouth opening or aggravating activities, soft diet, jaw exercises, massage, non-steroidal anti-inflammatory drugs (NSAIDs), heat and/or cold, bite plate in the presence of bruxism, physiotherapy, mindfulness, yoga, meditation, acupuncture, splint therapy, cognitive behavioural therapy, paracetamol, and neuromodulatory medications (eg, amitriptyline, gabapentin) 1. Some key points to consider in the management of TMJ issues in a 63-year-old male with dentures include:
- Having the dentures evaluated for proper fit, as ill-fitting dentures can contribute to TMJ problems
- Using a night guard specifically designed to wear over dentures during sleep to reduce the effects of bruxism
- Practicing stress reduction techniques such as meditation or physical therapy exercises for the jaw muscles
- Using over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours with food) or acetaminophen (500-1000mg every 6 hours) to temporarily reduce pain and inflammation
- Considering consultation with a dentist specializing in prosthodontics or TMJ disorders for comprehensive evaluation and treatment if symptoms persist. It is essential to note that surgery should be considered only after non-response to conservative therapy, including arthrocentesis, arthroscopy, or open surgery of the temporomandibular joint 1.
From the Research
TMJ Issues in a 63-Year-Old with Dentures
- Temporomandibular joint (TMJ) disorder is defined by pain and/or loss of function of the temporomandibular joint and its associated muscles and structures 2.
- Teeth grinding can contribute to TMJ issues, and individuals with dentures are not exempt from experiencing these problems.
- The prevalence of TMJ disorders is most commonly seen in people aged 20-40 years, but it can occur at any age 3.
- Symptoms of TMJ disorders may include pain, impaired jaw function, malocclusion, deviation from the midline on opening or closing the jaw, limited range of motion, joint noises, and locking 3.
Treatment Options for TMJ Issues
- Conservative therapies for TMJ disorders include nonsteroidal anti-inflammatory drugs, muscle relaxants, benzodiazepines, antidepressants, and anticonvulsants 2.
- Minimally invasive injections, such as botulinum toxin, corticosteroids, platelet-rich plasma, hyaluronic acid, and prolotherapy with hypertonic glucose, can also be used to manage TMJ disorders 2.
- Pharmacological agents, including analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, corticosteroids, anxiolytics, muscle relaxants, antidepressants, anticonvulsants, and benzodiazepines, can be prescribed to treat TMJ disorders 3.
- The effectiveness of adding pharmacologic treatment with clonazepam or cyclobenzaprine to patient education and self-care for the treatment of jaw pain upon awakening has been studied, with cyclobenzaprine showing statistically significant results compared to placebo or clonazepam 4.
Considerations for a 63-Year-Old with Dentures
- While the provided studies do not specifically address the issue of TMJ disorders in individuals with dentures, it is possible for a 63-year-old with dentures to experience TMJ issues related to teeth grinding or other factors.
- A thorough evaluation by a healthcare professional is necessary to determine the cause of TMJ issues in an individual with dentures and to develop an appropriate treatment plan 3.