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Dentistry · Oral and maxillofacial surgery and facial fractures: temporomandibular disorders
Sample itemA 28-year-old woman has dull pain in front of the ear, worse on chewing, with tender masseter and temporalis muscles and a click on opening. MRI of the joint is normal. Which initial treatment is most appropriate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Counselling, soft diet and an occlusal splint
Myofascial pain dysfunction is the commonest temporomandibular disorder and responds to conservative measures such as reassurance, jaw rest, analgesics and a splint. Surgery is reserved for structural disease that fails this approach.
Option by option
A. Total joint replacement
Joint replacement is for end-stage structural disease.
B. Long-term opioids
Opioids are not appropriate for a chronic benign muscle pain condition.
C. Counselling, soft diet and an occlusal splint (correct)
Correct. Reversible conservative measures are first line.
D. Condylectomy
Condylectomy is irreversible and not indicated with a normal joint.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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