Therapeutic jaw exercises and interocclusal appliance therapy. A comparison between two common treatments of temporomandibular disorders.

From a total of 1344 consecutive patients referred to a TMD clinic, twenty-six patients fulfilled the strict inclusion criterias of TMD of mainly muscular origin. Half of the patients were assigned to receive treatment with an interocclusal appliance, the treatment being performed by a dentist. The other half was instructed to perform individualized therapeutic jaw exercises, and this treatment was managed by a dental assistant. The treatment result was evaluated after six months. The two treatments had a positive and equal effect upon both signs and symptoms of TMD. A further follow-up by questionnaire one to four years after the final clinical examination showed a lasting treatment result in most patients. Many patients, however, continued to perform jaw exercises and/or to wear their appliances. This indicates that these two treatments are mostly symptomatic and not causal. The conclusion of the present investigation is that therapeutic jaw exercises, managed by a dentist or a dental assistant, is a cost effective treatment with a prognosis comparable to a treatment with an interocclusal appliance and can thus be recommended as the first therapy of choice in patients with TMD of mainly muscular origin.