Last reviewed: 1 Mar 2023
Last updated: 19 Dec 2019
Summary
Definition
History and exam
Key diagnostic factors
- cyclic pain
- continuous pain
- joint noise
- abnormal mandibular movement
- masticatory muscle tenderness
More key diagnostic factors
Other diagnostic factors
- depression or anxiety
- headache, backache, earache, or neck pain
Other diagnostic factors
Risk factors
- female sex
- depression, anxiety, or stress
- malocclusion
- age 20 to 40 years
More risk factors
Diagnostic investigations
1st investigations to order
- no initial test
More 1st investigations to order
Investigations to consider
- panoramic radiograph
- ultrasound
- MRI
- CT or cone beam CT
More investigations to consider
Treatment algorithm
INITIAL
TMJ pain: at initial presentation
ACUTE
persistent pain after 2 weeks of joint rest
ONGOING
refractory pain or disability: osteoarthritis or internal derangement subtype
Contributors
Authors
Sandra McNeal, MD, DMD
Private Dental Practice
Amsterdam
NY
Disclosures
SM declares that she has no competing interests.
Peer reviewers
William Maixner, DDS, PhD
Professor
Department of Endodontics
University of North Carolina Dental Research Center
Chapel Hill
NC
Disclosures
WM declares that he has no competing interests.
Kamran Ali, BDS, FDS RCS, FCPS, FFDRCSI, MMEd, FHEA
Associate Professor
Clinical Lead in Oral Surgery
Plymouth University Peninsula Schools of Medicine & Dentistry
Plymouth
UK
Disclosures
KA declares that he has no competing interests.
Differentials
- Sinusitis
- Pericoronitis
- Chronic headache
More DifferentialsGuidelines
- Acquired temporomandibular disorders in infants, children, and adolescents
More GuidelinesPatient leaflets
Temporomandibular joint syndrome (clicking jaw)
More Patient leafletsLog in or subscribe to access all of BMJ Best Practice
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