Functional disorders (dysfunctions) are disorders in the normal interaction of teeth and muscles. These include:
- Teeth grinding
- Teeth clenching
- Cheek biting
- Tongue biting
Symptoms – complaints
Dysfunction is usually recognized by pain, but other complaints are also possible:
- Cracking or pain in the jaw joint
- Myalgia (muscle pain)
- Ringing in the ears (tinnitus)
- Chronic tension
- Frequent headaches (cephalgia)
- Poor mobility of the lower jaw
- Bite marks on cheeks or tongue
Pathogenesis (disease development) – etiology (causes)
On the one hand, functional disorders are caused by disturbances in the dentition, for example, too high fillings or ill-fitting dentures. On the other hand, stress and psychological problems are the main triggers for functional disorders.The body looks for a way to process unspoken or even unconscious problems.
Other possible causes include:
- Disorders of static or dynamic occlusion (clenching of the teeth).
- Primary temporomandibular joint disorders
- Trauma – e.g. occlusal trauma (damage to the periodontium (periodontium) caused by overloading/misloading of a tooth when the periodontium is normal).
If the dysfunctions remain untreated, they can contribute to the development of craniomandibular dysfunction (CMD).
Consequential diseases
If dysfunction persists for a long time without being recognized and treated, secondary diseases may occur. These include:
- Muscular tension
- Muscle hyper- or hypotrophies (muscle enlargement or reduction).
- Myalgia (muscle pain)
- Myositides (muscle inflammation)
- Myogeloses (nodular or bulge-shaped, clearly circumscribed hardening in the muscles; colloquially also called hard tension).
- Temporomandibular joint disorders
- Disc displacements
Diagnostics
Functional disorders are diagnosed with the help of a clinical and/or instrumental functional analysis.Likewise, characteristic changes such as grinding facets in teeth grinding or bite marks from tongue or cheek biting can be detected.
Therapy
In most cases, a single treatment measure is not sufficient to eliminate the disorders.
At the beginning of therapy, reversible methods such as splint therapy are preferred. If significant success is shown, irreversible measures such as grinding in sliding obstacles or orthodontic treatment may be used, depending on the cause and extent of the dysfunction.
Since several factors often contribute to the discomfort, it is not uncommon for a combination of treatment measures to be used to prevent the development or progression of a functional disorder:
- Elimination of sliding obstacles
- Removal of tilted or displaced teeth
- Dentures
- Orthodontic treatment
- Maxillofacial surgical treatment
- Psychological treatment
- Rarely surgical therapy of the temporomandibular joint.
- Thermotherapy or cryotherapy (heat or cold therapy).
- Physiotherapy – e.g. massages
The therapy restores the harmonious relationship between teeth, jaw and muscles.In the case of psychological causes, the cause of the dysfunction can be found out in cooperation with a psychologist and thus eliminated.Drug therapy.
In some cases, drug therapy is indicated, for example, in the case of persistent pain or psychological causes of functional disorders. Medications used include:
- Analgesics (painkillers)
- Non-steroidal anti-inflammatory drugs (NSAIDs) also called non-steroidal anti-inflammatory drugs (NSAPs) or NSAIDs (non-steroidal anti-inflammatory drugs); these are non-opioid analgesics that also have an anti-inflammatory (anti-inflammatory) effect
- Muscle relaxants – drugs against muscular tension.
- Tricyclic antidepressants – drugs against depression.
