Kosten's Syndrome: Causes, Symptoms, Diagnosis, and Treatment Characteristics

It's no secret that most of the children and adults are afraid of dentists. And, as a rule, many patients are sent to these specialists only in emergency cases: when there is a huge flux or unpleasant odor in the mouth due to the accumulated tartar. Periodic discomfort in the oral cavity is mostly attributed to too cold or sweet food, which can cause temporary inconveniences.

Description of the pathology of Kosten: who treats the disease?

Just as frivolous at first sight is Kosten's syndrome, the symptoms of which rarely cause patients to go for professional medical advice. This pathology is a dysfunction of the cartilaginous disc located in the temporomandibular joint. Often the disease is confused with the disease 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 - the syndrome of a pathological occlusion - falls into the field of view of the orthodontist. The chances of a positive result of treating the pathology are large enough only if you start therapy as early as possible. In many cases, when patients have an idea of what Kosten's syndrome is (causes, symptoms, diagnosis and remedies), after treatment for doctors at an early stage, treatment in the form of corrective devices and a simple diet is quite successful. In this case, the neglected form of the disease does not relieve the patient of the need for surgical intervention and a longer recovery.

Why can not we ignore the symptoms of the disease?

To understand what is Kosten's syndrome, what is the danger of this ailment, 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 in any direction the mobility of the joint, thanks to which a person has the opportunity to chew, talk, drink. When the load on both jaws begins to be distributed unevenly, the above cartilage disc is inflamed.

Prolonged disregard for the manifestations of the disease threatens with serious complications, therefore, due attention should be paid to such a problem as Kosten's syndrome. Symptoms, treatment of dysfunction largely depend on how long the patient lives with this pathology. Over time, there is degeneration and complete degeneration of the cartilaginous disc, which, in turn, significantly affects the motor activity of the joint - it can completely lose.

Do not be afraid of a visit to the dentist with Kosten dysfunction. The syndrome at the advanced stages is capable to bring to the patient a lot of troubles: beginning from impossibility to chew food and necessity to use it only through a probe, finishing 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 can not name the exact causes and the development of dysfunction of the jaw joint. The most likely factors for the appearance of the syndrome are orthodontists and dentists:

- mechanical damage, injuries, blows;

- absence of molars (in adults this is the 6th, 7th and 8th teeth, in children - the 4th and 5th dairy);

- dental scraping (bruxism);

- excessive load 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 physicians distinguish several groups of people who have a fairly high chance of discovering Kosten's dysfunction. Syndrome is often seen in patients if:

• Their age exceeds 50 years;
• In the menopause period in women, the probability of developing an illness increases several times in comparison with peers of the opposite sex;
• They have a hereditary predisposition;
• There is a tendency to osteoarthritis, rheumatism;
• Several chewing molars were removed.

Signs of ailment

The similarity of clinical manifestations of the pathology of the maxillofacial zone often causes errors in the diagnosis of Kosten's disease. The syndrome, discovered by the 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 occur in patients because of:

• Discomforting sensations in the process of chewing food (many try not to pay special attention to mild pain or try to eliminate unpleasant feelings with pain medication);
• Frequent clicks and crunch when opening the mouth;
• Limited mobility of the jaw joint;
• Constant overstrain of the masticatory muscles, especially in the mornings;
• Barely noticeable asymmetry of the face line;
• Irradiation of pain in the ear, eyes.

The experience of treatment of patients with Kosten's syndrome indicates that patients often go to the doctor already when there are headaches, almost complete immobilization of the joint occurs and the severity of hearing is significantly reduced. With this form of the disease, it is unlikely to solve the problem with sparing methods.

How to identify the disease during the examination?

Diagnose Kosten's syndrome, whose treatment is predetermined in large part by the degree of the development of the disease, can be identified by a simple three-phalanx test. This method is considered classic, and thanks to the high information content this method is trusted by the majority of practicing dentists.

Its essence is as follows: between the upper and lower central incisors maximally open the patient's mouth should pass unhindered three interphalangeal joints 2, 3 and 4 fingers of the doctor's hand. With the atrophy of the patient's chewing muscles, this can not be done.

Confirm or deny the likely diagnosis can other modern methods of examination:

- electromyography of the maxillofacial joint;

- Impedanceometric examination (necessary for an objective assessment of the middle ear condition);

- Radiography of the lower jaw;

- Computed tomography or magnetic resonance scanning (in severe cases).

Features of treatment of pathology

If you reduce the load on the affected joint, the patient will be able to completely get rid of jaw dysfunction. The treatment of Costen's syndrome implies a comprehensive approach, where the first step is to change the type of food consumed. It should be at least wiped off during the first month of therapy. To the list of products that, according to dentists, have an ideal consistency, include sour-milk products, boiled porridges, juices. Hard chops and steaks are best avoided altogether, but this does not mean that you can not eat steam cutlets, meatballs, meat soufflings, etc.

It is extremely important to fully rest and sleep at least 7 hours a day. When passing a treatment course, the doctor may require the patient to minimize long conversations and use of chewing gums. It should also be remembered that any overstrain and stress can provoke pain, so unrest should be avoided.

Passage of physiotherapy and sanitation of the oral cavity

The mandatory medical procedures include:

• Massage of facial muscles;
• Laser therapy;
• Ultrasound therapy ;
• Iontophoresis.

An obligatory stage in the treatment is sanitation of the oral cavity, as well as prosthetics of missing teeth. Perhaps a specialist will appoint a patient to wear dental caps, stinging plates, mouth opening limiters, etc.

Drugs or surgery

To the medicamentous part of the therapy are transferred in those cases when the minimally invasive above methods are ineffective. To eliminate painful symptoms, prescribe analgesic and anti-inflammatory drugs. You can not do with the comprehensive elimination of Kosten's syndrome and without enhanced vitamin therapy in the form of tablets or injections. It is also possible the appointment of muscle relaxants, the purpose of which is considered to be the fight against hypertension of the masticatory muscles.

Surgical removal of the cartilaginous disk is rarely used, since numerous contraindications and the presence of risks of subsequent complications are the main obstacles to the operation. However, today, in complex cases, highly qualified specialists use the technique of installing a transplant, which can restore the full functioning of the maxillofacial joint.