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Flashcards in TMD OMG Deck (85)
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1
Q

Unilateral Splint

*brings one side down

A

Pivot Splint

2
Q

Migraine Headach is hereditary, has multiple triggers, and is Hypersensitivity of what?

A

Trigeminal Nerve

3
Q

Trigeminal nerve pain associated with TMD is highly associated with what hereditary hyperexcitability disorder?

A

Migraine

4
Q

A Pivot Splint creates a teeter totter effect side to side that can pull down the ________ on one side to alleviate ________

A

Condyle

Capsulitis

5
Q

Anterior Repositioning Appliance does what?

Treats what?

A

Moves jaw forward

Posterior capsulitis/locking on the disc

6
Q

De-afferentation pain

A

Phantom pain

7
Q

What kind of test can we do to determine Nerve Pain location?

A

Topical anesthesia

8
Q

What is the most common type of headache?

*gets better w/ activity

A

Tension

*migraine does NOT get better w/ activity

9
Q

Use peripheral topical anesthetic for…

This wouldn’t help for…

Topcal =

A

Peripheral nerve pain

Abscess tooth

Nerve pain

10
Q

Which muscle would limit side to side movement?

A

Lateral Pterygoid

11
Q

Severe unilateral orbital headache that makes you want to bang head against the wall

*more men

A

Cluster headache

12
Q

Nerve pain is more likely to be what type?

A

Sharp, shooting, electric

13
Q

Infection pain is more likelyto be…

A

Dull, achy

14
Q

Drug class that can Tx Migraine AND Nerve pain:

A

Tricyclic antidepressants

15
Q

Cutaneous allodynia

A

Light touch pain associated w/ Migraine

16
Q

5 Tx’s for TTH (tension type headaches)

A

PT

Antidepressants (tricyclics)

Muscle relaxants

Biofeedback

Trigger point injections

17
Q

3 Tx’s for Migraines:

A

Reduce triggers

Reduce body response to triggers (biofeedback/meds)

Abortive (meds/interventions)

18
Q

Topomax used for what?

Why?

A

Migraine

Anti-convulsant

19
Q

What drug is good at stopping Migraines?

A

Triptans

20
Q

4 Prophylactic Tx’s for Migraines:

A

Amitriptlyline

Beta Blockers

Ca channel blockers

Clonidine/coproheptadine/methysergide/naproxen

21
Q

4 abortive Tx’s for Migraine:

A

Ertgotamine (caffeine)

Ergotamine derivatives

Isometheptene

Sumatriptan

22
Q

Symptomatic relief for Migraines can be from aspirin, acetaminophen, codeine, etc

A

True

23
Q

Beta Blockers can be used for Migrain and Nerve pain

A

False

***migraine only

24
Q

What is the only anti-seizure med to Tx migraine?

A

Topomax

25
Q

Triptans are a _______ therapy for Migraines

They are not a _____ med

A

Abortive

Pain

26
Q

Hormones, CO, sensory overload, foods/beverages, drugs, stress, etc

A

Triggers for Migraine

27
Q

Tx for TTH (tension type headaches)

A

PT

Biofeedback

TCA, trigger point injections

Muscle relaxants

28
Q

Tx for Migraine

A

Reduce all triggers

Reduce body’s response to triggers (biofeedback, meds)

Abortive Tx’s. (meds/interventions)

29
Q

If you have more than ____ migraines/month, consider Prophylaxis

A

6/month

30
Q

3 categories of pharmacologic relief for migraines

*for test, should be able to name some in each category

A

Prophylactic

Abortive

Symptomatic

31
Q

Large, myelinated, tactile, proprioceptive nerve types:

A

A alpha

B beta

A gamma

32
Q

Small myelinated, pain pricking, touch warmth, cold

Nerve types

A

A delta

33
Q

Unmyelinated, pain, burning, itch, warm, cold nerve type

A

C

34
Q

5 comorbidities of Sleep Apnea

A

Overweight

Snore

Large neck (15/17)

Always tired

Persistent headaches w/ no obvious cause

35
Q

TTH must have 2 of what 3 symptoms?

A

Non-pulsating pressing/tightening

Bilateral

Physical activity doesn’t aggravate

36
Q

Nausea/vomiting and photophobia aren’t associated with what type of headache?

A

TTH

37
Q

TTH have no evidence of organic disease and is fewer than 15 days/month

A

True

38
Q

Migraine w/o aura lasts how long?

Location?

Quality?

Aggravated by what?

A

4-72 hours

Unilateral

Pulsating

Physical activity

39
Q

Migraine WITH aura, headache is preceded by 1 symptom that is Visual (3):

Or sensory (4):

A

Scintillating scotoma, Fortification spectra, Photopsia

Paresthesia, numbness, unilateral weakness, speech disturbance (aphasia)

40
Q

If topical doesn’t work, you might have Neuritis, Traumatic neuralgia, and Neuroma

A

True

41
Q

Beta blockers are used for Migraine but not ________

A

Nerve pain

*otherwise, similar Tx

42
Q

4 “favorite” drug used for Migraines:

A

Inderal 20 mg

Verapamil 40 mg

Pamelor (TCA, Na blocker, noradrenergic, seritonergic)

Topamax 15 mg

43
Q

Cluster Headache is ______ and lasts _______

And has 1 of the following: conjuctival infection, facial swelling, lacrimation, miosis, nasal congestion, ptosis, rhinorrhea, eyelid edema

A

Unilateral, 15-180

44
Q

Develops most often in women in menarche or early 20’s

Occurs at the time of menstruation for ____% of female sufferers

Affected by the life cycle events and therapeutic interventions and historically it is difficult to Tx

A

Menstrual Migraine

60%

True

45
Q

5 diagnostic Red Flags for Headaches:

A

Rash/meningeal signs/fever

After 50

HIV/cancer

Worsening pain

Focal neurologic disease

46
Q

What is the most accepted theory on migraine pathogenesis?

A

Neurovascular

47
Q

People w/ certain types of untreated malocclusion are more likely to develop TMD

What types of occlusion predispose to TMD?

A

False

Vertical/horizontal overjets greater than 3mm

Lateral slided greater than 3mm

48
Q

If you get an Aura, this is always migrain

A

True

*never TTH

49
Q

Cluster headache will often wake you up in middle of night

A

True

50
Q

Sinus headache is really rare, when is the only time you get?

A

Fever, gunk coming out of nose

51
Q

People with excessive incisal guidance or no incisal guidance are more likely to develp TMD

A

False (this is a myth)

52
Q

The only 2 Anticonvulsants used for migraines:

Others used for nerve pain

A

Depicote

Topamax

53
Q

As dentists you can prescribe these things for Migraines as long as you are competent

A

True

54
Q

People with gross maxillomandibular skeletal disharmoniesa are more likely to develop TMD

Modification…

A

False (myth!)

Can but are NOT more likely to predispose to TMD

55
Q

Pivot is the Teeter-Totter effect, pulls down and is for what disorder?

A

Lateral

56
Q

Sometimes tinnitis can be addressed by making a splint than moves the condyles forward

A

True

57
Q

Pretreatment radiographs of both TMJ’s should be taken to determine the position of the condyles/fossae, and ortho Tx should be directed toward getting condyles in concentric relation to their fossa

A

False (myth)

***Ortho Tx is Contraindicated, remember

58
Q

Ortho Tx, when properly done, usuallly reduces the likelihood of subsequently developing TMD

A

False (myth)

*doesn’t cause, doesn’t cure

59
Q

Finishing ortho cases according to specific functional occlusal guidelines will reduce the likelihood of developing TMD

A

False (myth)

60
Q

The use of certain traditional procedures (bicuspid extraction, incisor retraction) or appliances (headgear, chin cups, class II elastics) may increase the likelihood of developing TMD

A

False (myth)

Although, devices CAN aggravate pre-existing TMJ condition

61
Q

Adult pts who have concurrent TMD symptoms and some form of occlusal “problem” require some type of occlusal correction in order to get well and stay well

A

False (myth)

62
Q

The retrusion of the mandible b/c of natural causes (deep overbite, distalizing occlusal contacts) or iatrogenic procedures (chin cups, incisor retraction, retention during growth spurts) is a major factor in the development of TMD

A

False (myth)

63
Q

Distalization of the mandible causes articualr disks to slip forward off the condyles, resulting in internal derangements, especially clicking

A

False (myth)

***comment: Posterior condyle position Predisposes for anterior disc displacement with reduction but not for pain/arthritic changes

64
Q

Posterior/distalization of the mandible predisposes for what?

but not for what?

A

anterior disc displacement with reduction

pain/arthritic changes

65
Q

Controlled studies fail to demonstrate any association between _______ and TMD signs/symptoms

However, new research indicates a ____% relationship

A

occlusal interferences

15%

66
Q

TMD conditions, other than condylar auto-repositioning secondary to intracapsular arthrosis, are not associated with any _______

However, slides greater than ___mm are significant

A

slide length or assymetries

3mm

67
Q

Occlusal guidance patterns are not associated with TMD symptom provocation or conversely health

A

True

68
Q

Parafunction appears to be universal and is not associated with TMD development or symptomology in healthy individuals

With what exception?

A

True

Anterior bruxing is a Predisposing factor

69
Q

Sudden changes in occlusion can often cause TMD

A

True

*like a crown

70
Q

Dental attrition is not associated with TMD, with what exception?

A

Anterior Bruxism

71
Q

4 Parameters of Normal Occlusion:

A

Neutral

No anterior open or crossbite

Overjets less than 5mm, Slides less than 2 mm

No notable attrition

72
Q

Parameters of Occlusion for TMD prediction in patients

*3 things

A

Anterior Open Bite

over 2mm slides, over 5mm overjet

5 or more missing/unreplaced Posterior Teeth (excluding 3rd Molars)

73
Q

Morphologic malocclusion is often a consequence of TMD

However,

A

False

intracapsular TMJ diseases

74
Q

There is no evidence for Prophylactic TMD Tx

There is no evidence for Phrophylactic occlusal therapy

A

True

True

75
Q

Occlusal factors explain only a small part of TMD, contributing ___%

Etiologic interpretations can’t be drawn from prevalence based models

Isolated single occlusal variables have little predictive value

TMD requires multiple sets of multifactorial models and factor combos are disease specific

A

15%

True

True

True

76
Q

Stabilization appliance is a Nightguard

A

True

77
Q

What 3 adverse effect do all appliances have?

A

Caries

Soft tissue health

psychological dependence

78
Q

Anterior positioning appliance does what?

A

pulls forward

79
Q

Anterior Bite appliance, aka NTI, disoccludes where?

This has what 4 adverse effects?

A

Posterior

Anterior open bite from Posterior eruption, increase joint loading, ant mobility, aspiration

80
Q

NTI =

also used for what?

A

Anterior Bite Appliance

migraines

81
Q

Posterior Bite Appliance has what 2 potential Adverse effects?

A

intrusion of posterior teeth

change in condylar position

82
Q

A pivot appliance may _____ the pivot tooth

A

Intrude

83
Q

Resilient appliance is a protective Athletic appliance than may have what 2 adverse effects?

A

increase bruxisim

irritate soft tissue

84
Q

Distraction appliance increases discal space/recaptures displaced disc and may _____ the teeth

A

Intrude

85
Q

Appliance that may irritate soft tissues and not last long

A

Hydrostatic appliance

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