Four types of medication haw been widely used in the treatment of temporomandibular disorders: O./NSAIDs, (2) occasional. use of stronger analgesics, (3) muscular relaxants, and (-l) tricyclic antidepressants.
NSAIDs not only reduce inflammation but also serve as an excellent analgesic. Some examples of TSAIDsare naproxen (Naprosyn), ibuprofen (Morrin), diflunisal (Dolobid), and piroxicarn (Feldene). These medications
can be effective in reducing inflammation in both muscles and joints and in most cases provide satisfactory pain relief. These drugs are not associated with severe addiction problems, and their use (IS an anagesic is strongly
preferred over narcotic medications. It is important to remember that these medications work best when administered on a timetable rather than on a pain-dependent schedule. Patients should be instructed to take the medicine on a regular basis, obtaining an adequate.blood level that should then be maintained for a minimum of 7 to 10 days. Discontinuation or tapering of the medii: e can then be attempted. . The COX-2 inhibitors such as and have gained popularity in the treatment of inflammation and pain. Prostaglandins produced by COX-l activity appear to be required for normal physiologic function, whereas those produced by COX-2 activation mediate pain and Inflammation. The COX-2 inhihitors are intended to reduce pain and inflammation “lthout affecting prostaglandin-dependent functions. These drugs have been associated with significant side
effects, inc uding gastric and cardiac complications. ,\nalgesic medicines for T~!] patients may range from acetaminophen to potent narcotics. One important principle of treatment for all pain and dysfunction patients is