(English) Episode 29-Decoding TMDs - Unraveling Jaw Pain, Headaches, and Unexpected Connections

Temporomandibular disorders affect between 5% and 12% of the population and present with symptoms such as headache, bruxism, pain at the temporomandibular joint, jaw popping or clicking, neck pain, tinnitus, dizziness, decreased hearing, and hyperacuity to sound. Common signs on physical examination include tenderness of the pterygoid muscles, temporo-mandibular joints, and temporalis muscles, and malocclusion of the jaw and crepitus.The diagnosis is based on history and physical examination; however, use of computed tomography or magnetic resonance imaging is recommended if the diagnosis is in doubt. Nonpharmacologic therapy includes patient education (e.g., good sleep hygiene, soft food diet) and physical therapy. Pharmacologic therapy includes nonsteroidal anti-inflammatory drugs, cyclobenzaprine, tricyclic anti-depressants, and gabapentin. Injections of the temporomandibular joints with sodium hyaluronate, platelet-rich plasma, and dextrose prolotherapy may be considered, but the evidence of benefit is weak. A referral to oral and maxillofacial surgery is indicated for refractory cases.(Matheson EM, Fermo JD, Blackwelder RS. Temporomandibular disorders: Rapid evidence review. Am Fam Physician. 2023;107(1):52–8.)