From the Guidelines
Temporomandibular joint (TMJ) disorders can be categorized into several distinct types, including myofascial pain disorder, internal derangement, and degenerative joint disease, with myalgia being the most prevalent subtype, as noted in the 2023 BMJ study 1. The main types of TMJ disorders are:
- Myofascial pain disorder, characterized by pain and discomfort in the muscles controlling jaw movement
- Internal derangement, involving a displaced disc, clicking sounds, or restricted jaw movement
- Degenerative joint disease, which includes osteoarthritis or rheumatoid arthritis affecting the TMJ Other less common types include:
- TMJ dislocation, where the jaw becomes stuck in an open position
- Ankylosis, a severe condition causing joint fusion and limited movement
- TMJ disorders associated with systemic conditions like fibromyalgia or autoimmune diseases According to the 2023 BMJ study 1, the management of chronic pain associated with TMJ disorders should prioritize conservative approaches, including:
- Reassurance and education
- Avoidance of wide mouth opening or aggravating activities
- Soft diet
- Jaw exercises
- Massage
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Heat and/or cold therapy
- Bite plate in the presence of bruxism
- Physiotherapy
- Mindfulness, yoga, meditation, acupuncture, splint therapy, cognitive behavioural therapy, paracetamol, and neuromodulatory medications (eg, amitriptyline, gabapentin) Surgery should be considered only after non-response to conservative therapy, including arthrocentesis, arthroscopy, or open surgery of the temporomandibular joint, as recommended by the Temporomandibular disorder: a guide for general dental practitioners guideline 1.
From the Research
Types of TMJ Disorders
- Myofascial pain dysfunction syndrome (MPDS) or temporomandibular joint dysfunction syndrome (TMJDS) 2, 3
- Myogenic facial pain (MFP) 3
- TMJ internal derangement (TMJID) 3, 4
- Atypical facial pain (AFP) 3
- Temporomandibular joint pain (arthralgia, arthritis) 5
- Masticatory muscle pain (myofascial TMD) 5
Characteristics of TMJ Disorders
- Pain in the TMJ and muscles of mastication 2, 3
- Limited or deviant opening of the mandible 2, 3
- Joint sounds 2, 3
- Meniscus displacement present with TMJID patients 3
- Pain distribution patterns between the two groups (MFP and TMJID) 3
- Vague and wandering pain in the maxilla or mandible (AFP) 3