Temporomandibular Disorders: A Literature Review

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Temporomandibular disorders (TMD) are a group of clinical conditions that commonly present with the following symptoms: pain in or about jaw joint, with, or without the relating masticatory muscle pain; and/or limited jaw movements with, or without the accompanying joint sounds. Literature review has revealed that TMD is the most prevalent chronic pain condition in the orofacial region, with estimated 5% to 10% of the general population seeking orofacial pain relief. Given TMD can negatively impact one’s work, family life, and social engagement, as well as nutritional deficiencies secondary to the compromised masticatory function, understanding of its etiology and pathophysiology is paramount in formulating effective pain management and functional …show more content…

The precise interrelationship between muscle pain and motor function has been the topic of much debate, with two major, but conflicting theories emerging over the years: the Vicious Cycle Theory and the Pain Adaptation Model.

The Vicious Cycle Theory proposes that orofacial pain is initiated, and sustained by factors such as structural abnormality, eccentric movement, postural changes, and stress, which provoke local inflammatory responses and subsequent peripheral nervous system sensitisation, resulting in muscle spasm or fatigue that perpetuates pain and dysfunction cycle.

The Pain Adaptation Model proposes that the pathophysiology of orofacial pain is more than local inflammatory responses and peripheral nervous system sensitisation, rather, it is the result of a complex interaction between the peripheral and central nervous systems, resulting in muscle activity adjustments that limit movement and thereby protecting orofacial skeletomotor system from further harm and promote healing.

Neither theories, however, can adequately explain orofacial pain in its

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