Face / Head / Neck

Temporomandibular (TMJ) dysfunction

Definition

TMJ dysfunction is pain caused by functional and/or structural abnormalities of the temporomandibular joint.

Aetiology

TMJ dysfunction can be subdivided into muscular, discogenic and arthrogenic disorders.

Prevalence, based on the demand for pain treatment, is between 3% and 7% of the population. Aetiological risk factors are age, hypermobility, occlusion disorders, female gender, Whiplash Associated Disorders, prolonged gum chewing and teeth grinding.

Signs and symptoms

Most patient experience pain around the ear, whether or not in combination with pain radiating to the upper jaw. Eating and talking can provoke the pain. Headache and neck pain may co-exist.

Diagnostics

Physical Examination

Pain on palpation of the temporomandibular joint is a clear sign of TMJ dysfunction.

Additional Somatic Diagnostics

When there is resistance to therapy, a dental surgeon should be requested to perform additional examinations.

Additional Psycho-cognitive Diagnostics

  • RAND-36 (quality of life)
  • VAS-Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis.  Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment comprising various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

Other Treatments

  • Primary treatment by a dentist or dental surgeon

Interventional Pain Treatment