It's no secret that most children and adults are afraid of dentists. And, as a rule, many patients are sent to see these specialists only in emergency cases: when a huge flux or an unpleasant smell in the mouth due to accumulated tartar appears. Periodic discomfort in the oral cavity is mainly attributed to too cold or sweet food, which can cause temporary inconvenience.
Description of Kosten's pathology: who treats the disease?
Equally frivolous at first glance is Kosten's syndrome, the symptoms of which rarely cause patients to go for professional medical advice. This pathology is a dysfunction of the cartilage disc located in the temporomandibular joint. Often, the disease is confused with the ailment of the entire jaw apparatus. It is known that the treatment of such pathologies is not done by dentists, but by rheumatologists and orthopedists.
Kosten's disease - a syndrome of pathological bite - falls into the field of vision of the orthodontist. The chances of a positive result of the treatment of pathology are large enough only if the therapy is started as soon as possible. In many cases, when patients have an idea of what Kosten syndrome is (causes, symptoms, diagnosis and methods of eliminating the problem), after contacting doctors at an early stage, treatment in the form of wearing corrective devices and following a simple diet is quite successful. In this case, the advanced form of the disease will not save the patient from the need for surgical intervention and a longer recovery.
Why can't you ignore the symptoms of the disease?
To understand what Kosten’s syndrome is and why this disease is dangerous, you can understand the anatomical features of the maxillofacial structure of a person. Between the lower jaw and the skull base is a cartilaginous disc. Its task is to provide joint mobility in any direction, due to which a person has the ability to chew, speak, drink. When the load on both jaws begins to be distributed unevenly, inflammation of the above cartilaginous disc occurs.
Prolonged ignoring of the manifestations of the disease threatens serious complications, so you should pay due attention to such a problem as Kosten syndrome. Symptoms, treatment of dysfunction largely depend on how long the patient lives with this pathology. Over time, dystrophy and complete degeneration of the cartilaginous disc occurs, which, in turn, significantly affects the locomotor activity of the joint - it can be completely lost.
Do not be afraid to visit a dentist with Kosten dysfunction. The syndrome in the later stages can bring a lot of troubles to the patient: starting 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 over 80 years. However, to date, researchers still cannot name the exact causes of the occurrence and development of jaw joint dysfunction. The most likely factors for the appearance of the syndrome, orthodontists and dentists consider the following:
- mechanical damage, injury, shock;
- the absence of molars (in adults it is the 6th, 7th and 8th teeth, in children - the 4th and 5th milk);
- tooth grinding (bruxism);
- excessive loads on the joint;
- stressful situations;
- dislocation of the joint when visiting the dentist.
Nevertheless, most experts agree that the cause of the development of pathological displacement and inflammation of the cartilaginous disc is an incorrect bite.
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 identify several groups of people who have a fairly high chance of detecting Kosten dysfunction. The syndrome is often found in patients if:
- their age exceeds 50 years;
- during menopause in women, the likelihood of developing an ailment increases several times in comparison with peers of the opposite sex;
- they have a hereditary predisposition;
- there is a tendency to osteoarthritis, rheumatism;
- removed several chewing molar teeth.
Signs of ailment
The similarity of the clinical manifestations of pathologies of the maxillofacial zone often causes errors in the diagnosis of Kosten's disease. The syndrome, the discoverer of which was the American ENT doctor, can often not make itself felt by patients for a long time.
However, the first suspicions of the development of the disease arise in patients due to:
- uncomfortable sensations during chewing food (many try specifically not to pay attention to mild pain or try to eliminate unpleasant feelings with painkillers);
- frequent clicks and crunching when opening the mouth;
- limited mobility of the jaw joint;
- constant overstrain of the masticatory muscles, especially in the morning;
- barely noticeable asymmetry of the face line;
- irradiation of pain in the ear, eyes.
Experience in treating patients with Kosten syndrome indicates that patients often go to the doctor even when headaches occur, the joint is almost completely immobilized, and hearing acuity is significantly reduced. With this form of the disease, it is unlikely that the problem can be solved with gentle methods.
How to identify ailment during the examination?
Diagnose Kosten syndrome, the treatment of which is largely determined by the degree of development of the disease, can be detected by a simple three-phalanx test. This method is considered classic, and due to the high information content, most practicing dentists trust this method.
Its essence is as follows: between the upper and lower central incisors of the patient’s maximally open mouth, three interphalangeal joints of the doctor’s fingers 2, 3 and 4 should freely pass. With atrophy of the patient's masticatory muscles, this will not be possible.
Confirm or refute the probable diagnosis can other modern methods of examination:
- electromyography of the maxillofacial joint;
- impedance measurement (necessary for an objective assessment of the condition of the middle ear);
- radiography of the lower jaw ;
- computed tomography or magnetic resonance scanning (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 Kosten 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. The list of products that, according to dentists, have an ideal consistency includes fermented milk products, boiled cereals, juices. Hard chops and steaks are best avoided, however, this does not mean that you can’t eat steam cutlets, meatballs, meat soufflés, etc.
It is extremely important to fully relax and sleep at least 7 hours a day. When undergoing a treatment course, the doctor may require the patient to minimize long conversations and the use of chewing gums. It should also be remembered that any overstrain and stress can provoke pain, so unrest should be avoided.
Passing physiotherapy and sanitation of the oral cavity
Mandatory treatment procedures include:
- facial muscle massage;
- laser therapy;
- ultrasound therapy ;
- iontophoresis.
An obligatory step in the treatment is the rehabilitation of the oral cavity, as well as prosthetics for missing teeth. Perhaps the specialist will prescribe the patient wearing dental mouth guards, bite plates, mouth openers, etc.
Medication or surgery
The medicamentous part of therapy is transferred in those cases when the minimally invasive methods described above are ineffective. To eliminate the painful symptoms, analgesic and anti-inflammatory drugs are prescribed. You can not do with the comprehensive elimination of Kosten syndrome and without enhanced vitamin therapy in the form of tablets or injections. It is also possible the appointment of muscle relaxants, whose purpose is the fight against hypertonicity of the masticatory muscles.
Surgical removal of the cartilaginous disk is not often used, 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 a transplant placement technique that is able to restore the full functioning of the maxillofacial joint.