Temporomandibular Disorders and Its Management in Dentistry: A Review

Abstract

Temporomandibular disorders (TMD) is a collective term for a group of musculoskeletal conditions involving
pain and/or dysfunction in the masticatory muscles, temporomandibular joints (TMJ) and associated
structures. It is the most common type of non-odontogenic orofacial pain and patients can present with pain
affecting the face/head, TMJ and/or teeth, limitations in jaw movement and sounds in the TMJ during jaw
movements. Comorbid painful and non-painful conditions are also common among individuals with TMD.
The diagnosis of TMD have significantly improved over time with the recent Diagnostic Criteria for TMD
(DC/TMD) being reliable and valid for most common diagnoses, and an efficient way to communicate in
multidisciplinary settings. This classification covers 12 most common TMD, including painful (myalgia,
arthralgia and headache attributed to TMD) as well as the non-painful (disc displacements, degenerative
joint disease and subluxation) TMD diagnoses. Recent studies have demonstrated that the pathophysiology
of common painful TMD is biopsychosocial and multifactorial, where no one factor is responsible for its
development.
Importantly, research has suggested different predisposing, initiating and perpetuating factors, including
both peripheral and central mechanisms. This is an active field of investigation and future studies will not
only seek to clarify specific causal pathways but translate this knowledge into mechanism-directed diagnosis
and treatment. In accordance with this complex aetiology, current evidence supports primarily conservative
multidisciplinary treatment including self-management strategies, behavioural therapy, physical therapy and
pharmacotherapy. The aim of this review is to present an overview of most recent developments in aetiology,
pathophysiology, diagnosis and management of TMD.