Temporomandibular disorders (TMDs) are common painful multifactorial conditions affecting the temporomandibular joint (TMJ) and whose treatment depends on the type and symptoms. Initially, it requires pain control, and, for this, drugs, biting plates, occlusal adjustment, physiotherapy or their association are used. Lately, laser phototherapy (LPT) has been used in the treatment of pain of several origins, including TMDs. This study reports the treatment of a selected group of 74 patients treated at the Laser Center of the Federal University of Bahia between 2003 and 2008. Following standard anamneses, clinical and imaging examination and with the diagnosis of any type of TMD, the patients were prepared for LPT. No other intervention was carried out during the treatment. Treatment consisted of three sessions a week for 6 weeks. Prior to irradiation, the patients were asked to score their pain using a visual analog scale (VAS). Lasers of wavelength (lambda)780 nm, lambda790 nm or lambda830 nm and/or lambda660 nm were used at each session (30/40 mW; spot (varphi) approximately 3 mm; mean dose per session 14.2 +/- 6.8 J/cm(2); mean treatment dose of 170 +/- 79.8 J/cm(2)). Of the patients, 80% were female ( approximately 46 years old). At the end of the 12 sessions the patients were again examined, and they scored their pain using the VAS. The results were statistically analyzed and showed that 64% of the patients were asymptomatic or had improved after treatment and that the association of both wavelengths was statistically significant (P = 0.02) in the asymptomatic group. It was concluded that the association of red and infrared (IR) laser light was effective in pain reduction on TMJ disorders of several origins.
This paper discusses dental fluorosis as a relevant public health problem, using a review of epidemiological studies published in the last 10 years on the disease's prevalence, severity, and risk factors. The results suggest that there are already more cases than expected, although few studies refer to major severity. Thus, measures are needed for the prevention and surveillance of dental fluorosis.
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