Temporomandibular disorders

Temporomandibular disorders (TMDs) (previously temporomandibular joint syndrome) are a group of disorders associated with pain in the mouth and face that can progress to chronic pain.

TMDs typically present with four characteristic features: temporomandibular joint pain, noise in the joint, masticatory muscle tenderness, and limited mandibular movement.

TMDs can be self-limiting and can considerably affect quality of life.

Diagnostic Criteria for TMD, which comprises the Axis I (physical assessment) and Axis II (psychosocial assessment) domains, provides a standard criteria for the diagnosis of TMDs.

TMDs can primarily be treated by resting the affected joint.

Nonsteroidal anti-inflammatory drugs applied topically may help people with internal derangement (disk displacement) or osteoarthritis subtypes.

TMDs comprise several painful disorders involving the mandibular joint and muscles of mastication.[1]List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704. https://journals.sagepub.com/doi/10.1177/0333102416686302?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed http://www.ncbi.nlm.nih.gov/pubmed/28068790?tool=bestpractice.com [2]Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154. http://www.ncbi.nlm.nih.gov/pubmed/25767130?tool=bestpractice.com ​​​​ The characteristic features of TMDs include temporomandibular joint pain, noise in the joint, masticatory muscle tenderness, and limited mandibular movement. The presenting symptoms include one or all of the following: temporomandibular joint pain or pain in the muscles of mastication; temporomandibular joint clicking, popping, or crepitus with/without locking; headache in the temporal region; and otalgia and/or tinnitus without a significant ear disorder.[2]Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154. http://www.ncbi.nlm.nih.gov/pubmed/25767130?tool=bestpractice.com ​ The US prospective OPPERA multicenter study, which included patients with TMDs, defined TMD as "a complex condition with a biopsychosocial model of illness" and stated that it is no longer appropriate to regard TMDs as a localized jaw/dental condition.[3]The TMJ Association. Orofacial pain: prospective evaluation and risk assessment (OPPERA) [internet publication]. https://tmj.org/hope-in-research/landmark-studies/oppera-study ​ Disorders related to pain (myalgia, headache related to TMD, and arthralgia) and those associated with the temporomandibular joint (disk displacements, degenerative diseases) are the most common types of TMDs.[1]List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704. https://journals.sagepub.com/doi/10.1177/0333102416686302?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed http://www.ncbi.nlm.nih.gov/pubmed/28068790?tool=bestpractice.com ​ Chronic TMD is defined as pain lasting for ≥3 months.[4]Busse JW, Casassus R, Carrasco-Labra A, et al. Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline. BMJ. 2023 Dec 15;383:e076227. https://www.bmj.com/content/383/bmj-2023-076227.long http://www.ncbi.nlm.nih.gov/pubmed/38101929?tool=bestpractice.com ​ TMDs can have an impact on an individual’s quality of life.