Temporomandibular joint disorder


Temporomandibular Joint Disorder

Temporomandibular joint disorder (TMD) is also known as temporomandibular syndrome is a common type of musculoskeletal disorder in the orofacial region involving the masticatory muscles, temporomandibular joint (TMJ) and associated structures. The typical features are pain in the TMJ, restriction of mandibular movement, TMJ, and facial deformities. This activity will review the importance of the interprofessional team in the diagnosis and management of this condition.


  • Review the disorders associated with temporomandibular disorder (TMD).
  • Summarize the presentation of a patient with temporomandibular disorder (TMD).
  • Describe the workup of a patient with temporomandibular disorder (TMD).
  • It is essential to communicate and collaborate between providers as most patients with temporomandibular disorder (TMD) require a combined approach of both pharmacologic and non-pharmacologic measures, which can help reduce suffering and alleviate the symptoms of TMJ pain.

Temporomandibular joint disorders subdivide into three major categories:

1. Derangement of the condyle-disc complex: The derangement of the condyle disc complex arises due to a breakdown in the rotational function of the disc. This condition can result from the lengthening of ligaments (discal collateral and inferior retro-discal ligaments) or thinning of the posterior disc border. The contributing factors can be micro or macro trauma.

2. Structural incompatibility with articular surfaces: The disorder results from changes in the smooth sliding surfaces of the TMJ. The alteration causes friction, stickiness, and inhibits joint function. The structural incompatibility classifies as a deviation in form, adhesions, subluxation, and spontaneous dislocation.

   3. Inflammatory disorders of the TMJ: The joint disease of inflammatory origin characteristically presents with deep continuous pain that commonly gets accentuated on functional movement.  The continuous pain can trigger secondary excitatory effects. It expressed as referred pain, sensitivity to touch, protective contraction, or a combination of these problems. Inflammatory joints also get classified according to the structures involved, such as synovitis, capsulitis, retro-discitis, and arthritis.



Signs and symptoms of TMJ disorders may include

  • Pain or tenderness of your jaw
  • Pain in one or both of the temporomandibular joints
  • Aching pain in and around your ear
  • Difficulty chewing or pain while chewing
  • Aching facial pain
  • Locking of the joint, making it difficult to open or close your mouth

Cause of Temporomandibular joint disorder:

In many cases, the actual cause of this disorder may not be clear. Sometimes the main cause is excessive strain on the jaw joints and the muscle group that controls chewing, swallowing, and speech. This strain may be a result of bruxism. This is the habitual, involuntary clenching or grinding of the teeth. But trauma to the jaw, the head, or the neck may cause TMD. Arthritis and displacement of the jaw joint disks can also cause TMD pain. In other cases, another painful medical condition such as fibromyalgia or irritable bowel syndrome may overlap with or worsen the pain of TMD. A recent study by the National Institute of Dental and Craniofacial Research identified clinical, psychological, sensory, genetic, and nervous system factors that may put a person at higher risk of developing chronic TMD.

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