The role of pharmacy in the management of patients with temporomandibular disorders and orofacial pain.
OBJECTIVE
To provide information regarding the current understanding of the etiology and treatment, both nonpharmacologic and pharmacologic, of orofacial pain conditions including temporomandibular disorders (TMDs). This review briefly discusses the etiology and pathophysiology underlying the development of TMDs, generally accepted nonpharmacologic methods of treatment, and the most common current pharmacologic management approaches.


METHODS
Current medical literature and the authors' clinical experiences.


RESULTS
TMDs encompass a number of diagnostic subgroups that involve the masticatory musculature, the temporomandibular joint(s), and associated structures. More than 10 million individuals in the United States are affected by TMDs. Most current pharmacologic management approaches in the treatment of orofacial pain conditions, including TMDs, involve the use of antidepressants, anticonvulsants, muscle relaxants, corticosteroids, and nonsteroidal anti-inflammatory drugs.


CONCLUSIONS
Inclusion of pharmacists who are knowledgeable in the nonpharmacologic and pharmacologic treatment approaches on the TMD management team would improve therapeutic monitoring, follow-up, and outcomes in these patients.
Brazeau
G A
GA
Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville 32610-0494, USA. brazeau@cop.health.ufl.edu
Gremillion
H A
HA
Widmer
C G
CG
Mahan
P E
PE
Benson
M B
MB
Mauderli
A P
AP
Riley
J L
JL
Smith
C L
CL
D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001521:Behavior Therapy; D005157:Facial Pain / Q000628:therapy*; D006801:Humans; D026741:Physical Therapy Modalities; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000628:therapy*
D000927:Anticonvulsants; D000928:Antidepressive Agents