Osteoarthritis of the TMJ in teenaged females: report of cases.

From the cases reported by Ogus and those presented here, it appears degenerative joint disease of the TMJ in young individuals is not a rare finding. The incidence of DJD of the temporomandibular joint has been reported to be 8% to 16%. In a review of 346 patients who were referred for jaw disorders, 23 patients were 19 years old or younger. Six patients (or 26%) had a diagnosis of osteoarthritis of the TMJ confirmed with charts, reviewed retrospectively, were considered as suggestive of degenerative joint disease. It has been reported that the symptoms of DJD continue for one to three years. The majority of patients have acute symptoms that usually last about nine months but gradually subside after nine months. It is important to rule out degenerative disease of the TMJ before beginning radical or irreversible dental procedures. Conservative management of these patients includes analgesics, antiarthritic drugs, muscle relaxants, antiinflammatory agents, the construction of hard or soft bite splints, exercise, warm moist heat applications, minor equilibration if indicated, and physical therapy. Injections of steroids into the joint are not recommended and anti-arthritic drugs should be used with caution because the safe usage of some of these drugs has not been demonstrated in children. Patients who still experience pain after one to three years, or patients who are refractory to conservative therapy, may be candidates for surgical treatment. Age should not be a deterrent to surgery or other treatment modality for treatment of severe degenerative joint disease that does not respond to conservative treatment and is intolerable to the patient.