Abstract
Increased pain and/or discomfort during chewing, speaking, and swallowing have been commonly reported by patients with Temporomandibular Dysfunction (TMD). Speech-language pathology therapy (orofacial myofunctional therapy - OMT) has been proposed as part of the treatment for this condition; however, it is a modality that should be introduced when the TMD context and the pain are not accentuated, so that they do not prevent or hinder the performance of exercises. The aim of this study was to analyze the effect of OMT on the treatment of patients with TMD, according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), after analgesia with low-level laser therapy (LLLT), regarding orofacial myofunctional conditions (OMC) and the perception of TMD symptoms. Five patients aged 50 to 61 years were evaluated 30 days after completion of LLLT. An experienced speech-language pathologist conducted, pre- and post-OMT, the application of the ProDTM Multi-questionnaire - to investigate the self-perception of TMD symptomatology, and the Orofacial Myofunctional Evaluation with Scores (OMES) clinical examination - to confirm the orofacial myofunctional conditions. OMC presented increased OMT scores, indicating an increase in myofunctional orofacial balance. According to the patients' perception, TMD signs and symptoms were relieved after the application of OMT. According to the self-perception of the treated patients, introduction of OMT after LLLT analgesia promoted a balance of the orofacial functions of the sample studied, as well as a decrease in the remaining TMD signs and symptoms.
Highlights
The temporomandibular disorders (TMD) cover a set of changes related to the stomatognathic system, involving temporomandibular joints, the masticatory muscles and associated structures, and the presence of pain in these structures is the most frequent symptom[1,2]
The TMD context is characterized by a combination of signs and symptoms involving the orofacial region, of which pain is the main motivator for seeking appropriate treatment[2], and its relief is the first goal to be established
In a previous study[12], the degree of analgesia reached by level laser therapy (LLLT) was not permanent for all patients after 30 days, and it did not modify the orofacial myofunctional conditions (OMC), which could be acting as the TMD perpetuating factors
Summary
The temporomandibular disorders (TMD) cover a set of changes related to the stomatognathic system, involving temporomandibular joints, the masticatory muscles and associated structures, and the presence of pain in these structures is the most frequent symptom[1,2]. It is possible that such functional unbalances contribute as a coadjuvant in the hastiness or maintenance of TMD, and are characterized as risk factors or contributors to TMD[5,6]. Considering these aspects, the orofacial myofunctional therapy (OMT) has been proposed as part of the treatment of patients with TMD, in order to promote orofacial myofunctional balance[7,8] and minimize the contributing factors related to the functional conditions of the stomatognathic system. Interventions that act directly on analgesia mechanisms, such as the low level laser therapy (LLLT), favor the speech therapy at another time, when it is already possible for the patient to perform the exercises without causing pain, increasing the functional stability of the stomatognathic system[6]
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