Published online Feb 20, 2014. doi: 10.5321/wjs.v3.i1.10
Revised: November 11, 2013
Accepted: November 20, 2013
Published online: February 20, 2014
AIM: To evaluate a new therapeutic approach that may permanently address excessive involuntary muscle activity which causes temporomandibular disorders (TMD).
METHODS: A cohort of 69 TMD patients (33 men and 36 women, age range 14-71 years) was treated with Subconscious Temporomandibular Dysfunction (STeDy) therapy. A thick awareness splint assisted patients to gradually recognize the interdependence between psychological pressure and subconscious muscle activity. The STeDy therapy lasted for one year and involved three stages: (1) data collection including medical history, clinical examination and psychological evaluation; (2) application of the awareness splint and consultation on a monthly basis; and (3) final evaluation.
RESULTS: About 10% of patients (3 men and 4 women) quit the STeDy therapy within the first 3-6 mo due to severe health problems or psychosocial reasons. Based on the absence of objective and subjective clinical symptoms as well as on radiographic findings, the temporomandibular dysfunction treatment was successful in all remaining 62 patients that completed the year-long therapy. Symptoms, including recurrent headache, morning fatigue, clicking sound or painful temporomandibular joint disorders, were eliminated in all patients within the first six months. By completion of the STeDy therapy, all patients had learned to recognize stressful conditions and cognitively avoided displaying excessive bruxism or other subconscious activity of the stomatognathic muscles. A follow-up after at least one year indicated the permanent nature of the cognitive treatment in all patients, illustrating the fact that subconscious muscle activity due to stress plays a principal role in the great majority of TMD, at least in adults.
CONCLUSION: The STeDy therapy successfully and permanently resolved TMD problems of all patients that completed the year-long treatment.
Core tip: Despite the spectrum of variable symptoms, the pathology of temporomandibular disorders (TMD) is fundamentally a problem of excessive involuntary activity of certain stomatognathic muscles. The subconscious temporomandibular dysfunction (STeDy) therapy utilizes a thick awareness splint in order to gradually bring into the patient’s cognitive attention whatever stressful condition causes subconscious muscle activity. The STeDy therapy was applied for one year in 62 patients and successfully eliminated all TMD objective and subjective clinical symptoms as well as TMD-related radiographic findings. A follow-up after an additional year indicated the permanent nature of the cognitive treatment in all patients.