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temporomandibular joint syndrome

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According to the American Association of Orofacial Pain (AAOP) definition, a temporomandibular disorder (TMD) is:
 “a collective term embracing a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint and associated structures, or both.” (1)

Several terms have been used in the past to describe TMD which include Costen’s syndrome, temporomandibular joint dysfunction syndrome, temporomandibular joint disorders, and craniomandibular syndrome (1). 

Around 60-70% of the general population has at least one sign of a temporomandibular disorder (2)  

  • only 5% of patients with symptoms will seek treatment
  • most common in early adulthood (2) and in women than in men.
  • discomfort from these conditions is occasional and temporary
  • often they occur in cycles
  • the pain finally disappears with little or no treatment
  • some develop significant, long-term symptoms (3).

The conditions fall into three main categories (4):

  • myofascial pain
    • this is the most common temporomandibular disorder
    • it involves discomfort or pain in the muscles that control jaw function.
  • internal derangement of the joint
    • this involves a displaced disc, dislocated jaw, or injury to the condyle.
  • arthritis
    • this refers to a group of degenerative/inflammatory joint disorders affects the joint. 

Costen's syndrome arises from faulty articulation of the temporomandibular joint caused by one or more of:

  • dental malocclusion
  • emotional stress producing masseter spasm
  • overenthusiastic kissing

Short term treatment consists of a very soft diet and simple analgesia, and may be sufficient for mild symptoms.

Long term treatment may involve dental correction or stress relaxation. Referral to a specialist clinic may be needed.