Patients with chronic eating disorders have a high prevalence of TMD. The practitioner should inquire about daytime or nighttime clenching. Daytime clenching likely constitutes a stronger risk factor for myofacial pain than nighttime bruxism.
The patient may complain of any of the following symptoms:
Pain: Pain is usually periauricular, associated with chewing, and may radiate to the head but is not like a headache. It may be unilateral or bilateral in myofascial pain and dysfunction, and usually is unilateral in TMD of articular origin, except in rheumatoid arthritis. The pain is often described as a variable deep ache with intermittent sharp pain with jaw movement.
Click, pop, and snap: These sounds usually are associated with pain in TMD. The click with pain in anterior disk displacement is due to sudden reduction of the posterior band to normal position. An isolated click is very common in the general population and is not a risk factor for development of TMD.
Limited jaw opening and locking episodes: The lock can be open or closed; open lock is an inability to close the mouth and is seen when the mandibular condyle dislocates anteriorly in front of articular eminence. Closed lock is an inability to open the mouth because of pain or disk displacement.
Headaches: The pain of TMD is not like a usual headache. The TMD may act as a trigger in patients prone to headaches. TMD involving muscle pain predisposes to migraines and chronic daily headaches, and the more painful the TMD, the more likely it is to be associated with headache. Some patients may have a history of headaches resistant to treatment; therefore, the TMD trigger should not be overlooked in such patients.
For more on the presentation of TMD, read here.
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Cite this: Amy Kao. Fast Five Quiz: Test Yourself on Temporomandibular Disorder - Medscape - Mar 01, 2017.