It's no secret that most children and adults are afraid of dentists. And, as a rule, many patients go to these specialists only in emergency cases: when there is a huge flux or an unpleasant smell in the mouth due to accumulated tartar. Periodic discomfort in the oral cavity is mainly attributed to too cold or sweet food, which can cause temporary discomfort.
Description of Kosten's pathology: who treats the disease?
Costen's syndrome is just as frivolous at first glance, the symptoms of which rarely force patients to seek professional medical advice. This pathology is a dysfunction of the cartilage disc located in the temporomandibular joint. Often the disease is confused with the disease of the entire jaw apparatus. It is known that not dentists, but rheumatologists and orthopedists are engaged in the treatment of such pathologies.
Kosten's disease - pathological bite syndrome - falls into the field of view of the orthodontist. The chances of a positive outcome in the treatment of pathology are high enough only if therapy is started as early as possible. In many cases, when patients have an idea of what Costen's syndrome is (causes, symptoms, diagnosis, and methods for resolving the problem), after contacting doctors in the early stages, treatment in the form of wearing corrective devices and following a simple diet is quite successful. At the same time, the advanced form of the disease will not save the patient from the need for surgical intervention and a longer recovery.
Why can't I ignore the symptoms of the disease?
To understand what Costen's syndrome is, how dangerous this disease is, you can understand the anatomical features of the maxillofacial structure of a person. Between the lower jaw and the cranial base is a cartilaginous disc. Its task is to provide joint mobility in any direction, thanks to which a person has the ability to chew, talk, drink. When the load on both jaws begins to be distributed unevenly, the aforementioned cartilaginous disc becomes inflamed.
Prolonged ignoring the manifestations of the disease threatens with serious complications, so you should pay due attention to such a problem as Costen's syndrome. Symptoms, treatment of dysfunction largely depend on how long the patient lives with this pathology. Over time, dystrophy and complete degeneration occur.cartilage disc, which, in turn, significantly affects the motor activity of the joint - it can be completely lost.
Don't be afraid of visiting the dentist with Costen's dysfunction. The syndrome in the later stages can bring the patient a lot of trouble: from the inability to chew food and the need to eat it only through a probe, ending with the loss of intelligible speech.
Causes of the problem
Described by the American otolaryngologist Kosten in 1934, the syndrome has been studied for more than 80 years. However, to date, researchers still cannot name the exact causes of the onset and development of dysfunction of the jaw joint. The most likely factors for the appearance of the syndrome orthodontists and dentists consider the following:
- mechanical damage, injury, impact;
- absence of molars (in adults, these are the 6th, 7th and 8th teeth, in children - the 4th and 5th milk teeth);
- teeth grinding (bruxism);
- excessive stress on the joint;
- stressful situations;
- dislocation of the joint when visiting the dentist.
However, most experts agree that the cause of the development of pathological displacement and inflammation of the cartilage disc is malocclusion.
Regardless of whether it is congenital or acquired, it is extremely important to ensure that the load on both jaws is the same.
Who is at risk?
It turns out that doctors distinguish several groups of people who have fairly high chancesdetect Costen's dysfunction. The syndrome is often seen in patients if:
- their age is over 50;
- during menopause, women are several times more likely to develop the disease than their peers of the opposite sex;
- they have a hereditary predisposition;
- there is a tendency to osteoarthritis, rheumatism;
- removed several chewing teeth-molars.
Signs of illness
The similarity of clinical manifestations of pathologies of the maxillofacial zone often causes errors in the diagnosis of Costen's disease. The syndrome, which was discovered by an American ENT doctor, can often not make itself felt to patients for a long time.
However, the first suspicions of the development of the disease arise in patients due to:
- uncomfortable sensations while chewing food (many try to specifically ignore mild pain or try to eliminate unpleasant feelings with painkillers);
- frequent clicks and crunches when opening the mouth;
- limited jaw joint mobility;
- constant strain of masticatory muscles, especially in the morning;
- barely noticeable asymmetry of the facial line;
- irradiation of pain in the ear, eyes.
Experience in treating patients with Costen's syndrome suggests that patients often go to the doctor when headaches occur, there is almost complete immobilization of the joint and significantlyhearing loss is reduced. With this form of the disease, it is unlikely that it will be possible to solve the problem with gentle methods.
How to identify an ailment during the examination?
To diagnose Costen's syndrome, the treatment of which is largely determined by the degree of development of the disease, can be detected by a simple three-phalangeal test. This method is considered a classic, and due to its high information content, this method is trusted by most practicing dentists.
Its essence is as follows: between the upper and lower central incisors of the patient's maximally open mouth, three interphalangeal joints of the 2nd, 3rd and 4th fingers of the doctor's hand should pass freely. With atrophy of the masticatory muscles of the patient, this will not be possible.
Other modern methods of examination can confirm or refute the probable diagnosis:
- electromyography of the maxillofacial joint;
- impedance study (required for an objective assessment of the condition of the middle ear);
- X-ray of the lower jaw;
- computed tomography or magnetic resonance scan (in severe cases).
Features of the treatment of pathology
If you reduce the load on the affected joint, the patient will be able to completely get rid of jaw dysfunction. Treatment of Costen's syndrome involves an integrated approach, where the first step is to change the type of food consumed. It should be at least frayed during the first month of therapy. To the list of products that, according to dentists,ideal consistency, include fermented milk products, boiled cereals, juices. Tough chops and steaks are best avoided altogether, but that doesn't mean you shouldn't eat steam cutlets, meatballs, meat soufflés, etc.
It is extremely important to fully rest and sleep at least 7 hours a day. During the course of treatment, the doctor may require the patient to minimize long conversations and the use of chewing gum. It should also be remembered that any overexertion and stress can provoke pain, so unrest should be avoided.
Passing physiotherapy and sanitation of the oral cavity
Mandatory medical procedures include:
- facial muscle massage;
- laser therapy;
- ultrasound therapy;
- iontophoresis.
An obligatory stage in the treatment is the rehabilitation of the oral cavity, as well as the prosthetics of missing teeth. Perhaps the specialist will prescribe the patient to wear mouthguards, bite blocks, mouth opening restrictions, etc.
Medication or surgery
The medical part of therapy is switched to in cases where the above-mentioned minimally invasive methods are ineffective. To eliminate painful symptoms, analgesic and anti-inflammatory drugs are prescribed. You can not do with the complex elimination of Costen's syndrome and without enhanced vitamin therapy in the form of tablets or injections. It is also possible to prescribe muscle relaxants, the purpose of which is considered to be the fight againsthypertonicity of masticatory muscles.
Surgical removal of a cartilaginous disc is rarely resorted to, since numerous contraindications and the presence of risks of subsequent complications are the main obstacles to the operation. However, today, in difficult cases, highly qualified specialists use the technique of installing a transplant, which is able to restore the full functioning of the maxillofacial joint.
