Temporomandibular joint syndrome - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

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.

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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704.[Abstract][Full Text]
Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154.[Abstract]
Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27.[Abstract][Full Text]
Dimitroulis G. Temporomandibular disorders: a clinical update. BMJ. 1998;317:190-4.[Abstract][Full Text]
Kapur N, Kamel IR, Herlich A. Oral and craniofacial pain: diagnosis, pathophysiology and treatment. Int Anesthesiol Clin. 2003;41:115-50.[Abstract]
Acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry. 2019 [internet publication].[Full Text]

Referenced Articles

1. List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017 Jun;37(7):692-704.[Abstract][Full Text]
2. Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. BMJ. 2015 Mar 12;350:h1154.[Abstract]
3. The TMJ Association. Orofacial pain: prospective evaluation and risk assessment (OPPERA) [internet publication].[Full Text]
4. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27.[Abstract][Full Text]
5. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.[Abstract][Full Text]
6. Young AL. Internal derangements of the temporomandibular joint: a review of the anatomy, diagnosis, and management. J Indian Prosthodont Soc. 2015 Jan-Mar;15(1):2-7.[Abstract][Full Text]
7. Dimitroulis G. Temporomandibular disorders: a clinical update. BMJ. 1998;317:190-4.[Abstract][Full Text]
8. Kapur N, Kamel IR, Herlich A. Oral and craniofacial pain: diagnosis, pathophysiology and treatment. Int Anesthesiol Clin. 2003;41:115-50.[Abstract]
9. Slade GD, Fillingim RB, Sanders AE, et al. Summary of findings from the OPPERA prospective cohort study of incidence of first-onset temporomandibular disorder: implications and future directions. J Pain. 2013 Dec;14(7 suppl):T116-24.[Abstract][Full Text]
10. Lund JP, Widmer CG, Feine JS. Validity of diagnostic and monitoring tests used for temporomandibular disorders. J Dent Res. 1995;74:1133-43.[Abstract]
11. Acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry. 2019 [internet publication].[Full Text]
12. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997;8:291-305.[Abstract][Full Text]
13. Köhler AA, Helkimo AN, Magnusson T, et al. Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents. A cross-sectional epidemiological investigation covering two decades. Eur Arch Paediatr Dent. 2009 Nov;10(1 suppl):16-25.[Abstract]
14. Yadav S, Yang Y, Dutra EH, et al. Temporomandibular joint disorders in older adults. J Am Geriatr Soc. 2018 Jul;66(6):1213-7.[Abstract][Full Text]
15. Ohrbach R, Fillingim RB, Mulkey F, et al. Clinical findings and pain symptoms as potential risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study. J Pain. 2011 Nov;12(11 suppl):T27-45.[Abstract][Full Text]
16. Kroese JM, Volgenant CMC, Crielaard W, et al. Temporomandibular disorders in patients with early rheumatoid arthritis and at-risk individuals in the Dutch population: a cross-sectional study. RMD Open. 2021 Jan;7(1):e001485.[Abstract][Full Text]
17. Mortazavi N, Babaei M, Babaee N, et al. Evaluation of the prevalence of temporomandibular joint involvement in rheumatoid arthritis using research diagnostic criteria for temporomandibular disorders. J Dent (Tehran). 2018 Nov;15(6):332-8.[Abstract][Full Text]
18. Greenspan JD, Slade GD, Bair E, et al. Pain sensitivity risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case control study. J Pain. 2011 Nov;12(11 suppl):T61-74.[Abstract][Full Text]
19. Auerbach SM, Laskin DM, Frantsve LM, et al. Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients. J Oral Maxillofac Surg. 2001 Jun;59(6):628-33.[Abstract]
20. Mitrirattanakul S DDS, PhD, Jariyasakulroj S DDS. Dental treatment as perceived etiology of temporomandibular disorders. Cranio. 2020 Mar;38(2):109-14.[Abstract]
21. Shroff B. Malocclusion as a cause for temporomandibular disorders and orthodontics as a treatment. Oral Maxillofac Surg Clin North Am. 2018 Aug;30(3):299-302.[Abstract]
22. Aboalnaga AA, Amer NM, Elnahas MO, et al. Malocclusion and temporomandibular disorders: verification of the controversy. J Oral Facial Pain Headache. 2019 Fall;33(4):440-50.[Abstract]
23. Smith SB, Maixner DW, Greenspan JD, et al. Potential genetic risk factors for chronic TMD: genetic associations from the OPPERA case control study. J Pain. 2011 Nov;12(11 suppl):T92-101.[Abstract][Full Text]
24. Visscher CM, Lobbezoo F. TMD pain is partly heritable. A systematic review of family studies and genetic association studies. J Oral Rehabil. 2015 May;42(5):386-99.[Abstract]
25. Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med. 2008 Dec 18;359(25):2693-705.[Abstract]
26. Jedynak B, Jaworska-Zaremba M, Grzechocińska B, et al. TMD in females with menstrual disorders. Int J Environ Res Public Health. 2021 Jul 7;18(14):7263.[Abstract][Full Text]
27. Landi N, Lombardi I, Manfredini D, et al. Sexual hormone serum levels and temporomandibular joint disorders. A preliminary study. Gynecol Endocrinol. 2005;20:99-103.[Abstract]
28. Warren MP, Fried JL. Temporomandibular disorders and hormones in women. Cells Tissues Organs. 2001;169:187-192.[Abstract]
29. LeResche L, Mancl L, Sherman JJ, et al. Changes in temporomandibular pain and other symptoms across the menstrual cycle. Pain. 2003 Dec;106(3):253-61.[Abstract]
30. Plesh O, Adams SH, Gansky SA. Temporomandibular joint and muscle disorder-type pain and comorbid pains in a national US sample. J Orofac Pain. 2011 Summer;25(3):190-8.[Abstract][Full Text]
31. Kleykamp BA, Ferguson MC, McNicol E, et al. The prevalence of comorbid chronic pain conditions among patients with temporomandibular disorders: a systematic review. J Am Dent Assoc. 2022 Mar;153(3):241-50.e10.[Abstract]
32. Glaros AG. Emotional factors in temporomandibular joint disorders. J Indiana Dent Assoc. 2000-2001;79:20-23.[Abstract]
33. De Boever JA, Nilner M, Orthlieb JD, et al. Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner. J Orofac Pain. 2008;22:268-78.[Abstract]
34. The Royal College of Surgeons of England. Commissioning guide 2014: Temporomandibular joint disorders. 2014 [internet publication].[Full Text]
35. Temporomandibular disorders. American Association of Oral and Maxillofacial Surgeons. 2017 [internet publication].[Full Text]
36. Larheim TA, Abrahamsson AK, Kristensen M, et al. Temporomandibular joint diagnostics using CBCT. Dentomaxillofac Radiol. 2015;44(1):20140235.[Abstract][Full Text]
37. Krishnamoorthy B, Mamatha N, Kumar VA. TMJ imaging by CBCT: Current scenario. Ann Maxillofac Surg. 2013 Jan;3(1):80-3.[Abstract][Full Text]
38. Acquired temporomandibular disorders in infants, children, and adolescents. American Academy of Pediatric Dentistry. 2019 [internet publication].[Full Text]
39. Molin C. From bite to mind: TMD - a personal and literature review. Int J Prosthodont. 1999;12:279-88.[Abstract]
40. Shedden Mora MC, Weber D, Neff A, et al. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain. 2013;29:1057-65.[Abstract]
41. Penlington C, Bowes C, Taylor G, et al. Psychological therapies for temporomandibular disorders (TMDs). Cochrane Database Syst Rev. 2022 Aug 11;(8):CD013515.[Abstract][Full Text]
42. Arribas-Pascual M, Hernández-Hernández S, Jiménez-Arranz C, et al. Effects of physiotherapy on pain and mouth opening in temporomandibular disorders: an umbrella and mapping systematic review with meta-meta-analysis. J Clin Med. 2023 Jan 18;12(3):788.[Abstract][Full Text]
43. Fricton J, Look JO, Wright E, et al. Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders. J Orofac Pain. 2010;24:237-54.[Abstract]
44. Ebrahim S, Montoya L, Busse JW, et al. The effectiveness of splint therapy in patients with temporomandibular disorders: a systematic review and meta-analysis. J Am Dent Assoc. 2012;143:847-57.[Abstract]
45. Tournavitis A, Sandris E, Theocharidou A, et al. Effectiveness of conservative therapeutic modalities for temporomandibular disorders-related pain: a systematic review. Acta Odontol Scand. 2023 May;81(4):286-97.[Abstract]
46. Tran C, Ghahreman K, Huppa C, et al. Management of temporomandibular disorders: a rapid review of systematic reviews and guidelines. Int J Oral Maxillofac Surg. 2022 Sep;51(9):1211-25.[Abstract]
47. Riley P, Glenny AM, Worthington HV, et al. Oral splints for temporomandibular disorder or bruxism: a systematic review. Br Dent J. 2020 Feb;228(3):191-7.[Abstract][Full Text]
48. Kulkarni S, Thambar S, Arora H. Evaluating the effectiveness of nonsteroidal anti-inflammatory drug(s) for relief of pain associated with temporomandibular joint disorders: a systematic review. Clin Exp Dent Res. 2020 Feb;6(1):134-46.[Abstract][Full Text]
49. Montinaro F, Nucci L, d'Apuzzo F, et al. Oral nonsteroidal anti-inflammatory drugs as treatment of joint and muscle pain in temporomandibular disorders: a systematic review. Cranio. 2022 Feb 7:1-10.[Abstract]
50. Sidebottom AJ, Salha R. Management of the temporomandibular joint in rheumatoid disorders. Br J Oral Maxillofac Surg. 2013 Apr;51(3):191-8.[Abstract]
51. National Institute for Health and Care Excellence. Total prosthetic replacement of the temporomandibular joint. Aug 2014 [internet publication].[Full Text]
52. American Society of TMJ Surgeons. Surgical management of TMJ disorders [internet publication].[Full Text]
53. Cascos-Romero J, Vazquez-Delgado E, Vazquez-Rodriguez E, et al. The use of tricyclic antidepressants in the treatment of temporomandibular joint disorders: systematic review of the literature of the last 20 years. Med Oral Patol Oral Cir Bucal. 2009;14:E3-E7.[Abstract]
54. Ernst E, White AR. Acupuncture as a treatment for temporomandibular joint dysfunction: a systematic review of randomized trials. Arch Otolaryngol Head Neck Surg. 1999;125:269-272.[Abstract]
55. Fink M, Rosted P, Bernateck M, et al. Acupuncture in the treatment of painful dysfunction of the temporomandibular joint - a review of the literature. Forsch Komplementarmed. 2006;13:109-15.[Abstract]
56. Cho SH, Whang WW. Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain. 2010;24:152-62.[Abstract]
57. La Touche R, Angulo-Diaz-Parreno S, de-la-Hoz JL, et al. Effectiveness of acupuncture in the treatment of temporomandibular disorders of muscular origin: a systematic review of the last decade. J Altern Complement Med. 2010;16:107-12.[Abstract]
58. La Touche R, Goddard G, De-la-Hoz JL, et al. Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain. 2010;26:541-50.[Abstract]
59. Rosted P. Practical recommendations for the use of acupuncture in the treatment of temporomandibular disorders based on the outcome of published controlled studies. Oral Dis. 2001;7:109-15.[Abstract]
60. Melis M, Di Giosia M, Zawawi KH. Low level laser therapy for the treatment of temporomandibular disorders: A systematic review of the literature. Cranio. 2012;30:304-12.[Abstract]
61. Ahmad SA, Hasan S, Saeed S, et al. Low-level laser therapy in temporomandibular joint disorders: a systematic review. J Med Life. 2021 Mar-Apr;14(2):148-64.[Abstract][Full Text]
62. Ren H, Liu J, Liu Y, et al. Comparative effectiveness of low-level laser therapy with different wavelengths and transcutaneous electric nerve stimulation in the treatment of pain caused by temporomandibular disorders: a systematic review and network meta-analysis. J Oral Rehabil. 2022 Feb;49(2):138-49.[Abstract]
63. Racich MJ. Orofacial pain and occlusion: is there a link? An overview of current concepts and the clinical implications. J Prosthet Dent. 2005;93:189-96.[Abstract]