Temporomandibular Muscle Disorders

  • Edward F. WrightEmail author


  • Diagnosing and treating temporomandibular muscle disorders is a challenging yet very rewarding venture. It requires carefully listening to patients so as to obtain a thorough history and identify potential contributing factors. An in-depth clinical exam confirms or refutes the suspicious structures contributing to the temporomandibular muscle disorder.

  • Identifying and reducing the contributing factors is the key to developing the most cost-effective long-term management for patients with temporomandibular muscle disorders.

  • With the patients’ participation, methodically develop the most cost-effective treatment plan, focusing upon each patient’s identified contributors. TMD self-management and education are the foundation for empowering self-reliance and enhancing a positive patient to practitioner relationship.

  • Treatment often involves enlisting the help of other practitioners who provide therapies that are outside of the dentist’s realm of treatment, e.g., physical therapist and psychologist.

  • As treatments are implemented, ensure the patient’s temporomandibular muscle pain is sufficiently reduced and the masticatory function is restored.

  • Patients are not passive recipients of our therapies but are active partners in obtaining and maintaining their treatment goals.


  1. 1.
    de Leeuw R, Klasser GD, editors. Orofacial pain: guidelines for assessment, diagnosis and management, vol. 127. 5th ed. Chicago: Quintessence; 2013. p. 146–8.Google Scholar
  2. 2.
    Wright EF. Medial pterygoid trismus (myospasm) following inferior alveolar nerve block: case report and literature review. Gen Dent. 2011;59(1):64–7.PubMedGoogle Scholar
  3. 3.
    Clark GT. Classification, causation and treatment of masticatory myogenous pain and dysfunction. Oral Maxillofac Surg Clin North Am. 2008;20(2):145–57. vCrossRefPubMedGoogle Scholar
  4. 4.
    Fricton J. Myogenous temporomandibular disorders: diagnostic and management considerations. Dent Clin N Am. 2007;51(1):61–83.CrossRefPubMedGoogle Scholar
  5. 5.
    Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand. 2005;63(2):99–109.CrossRefPubMedGoogle Scholar
  6. 6.
    Wright EF. Otologic symptom improvement through TMD therapy. Quintessence Int. 2007;38(9):E564–71.PubMedGoogle Scholar
  7. 7.
    Wright EF. Manual of temporomandibular disorders. 3rd ed. Ames: Wiley Blackwell; 2014. p. 1–2. 31–70, 97–101, 114–6, 125–9Google Scholar
  8. 8.
    Velly AM, Fricton J. The impact of comorbid conditions on treatment of temporomandibular disorders. J Am Dent Assoc. 2011;142(2):170–2.CrossRefPubMedGoogle Scholar
  9. 9.
    Carlsson GE, Egermark I, Magnusson T. Predictors of bruxism, other oral parafunctions and tooth wear over a 20-year follow-up period. J Orofac Pain. 2003;17(1):50–7.PubMedGoogle Scholar
  10. 10.
    Okeson JP. Bell’s oral and facial pain. 7th ed. Chicago: Quintessence; 2014. p. 287.Google Scholar
  11. 11.
    Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6–27.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Blanco Aguilera A, Gonzalez Lopez L, Blanco Aguilera E, De la Hoz Aizpurua JL, Rodriguez Torronteras A, Segura Saint-Gerons R, Blanco HA. Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders. J Oral Rehabil. 2014;41(8):564–72.CrossRefPubMedGoogle Scholar
  13. 13.
    Madani AS, Abdollahian E, Khiavi HA, Radvar M, Foroughipour M, Asadpour H, Hasanzadeh N. The efficacy of gabapentin versus stabilization splint in management of sleep bruxism. J Prosthodont. 2013;22(2):126–31.CrossRefPubMedGoogle Scholar
  14. 14.
    Lindfors E, Nilsson H, Helkimo M, Magnusson T. Treatment of temporomandibular disorders with a combination of hard acrylic stabilisation appliance and a soft appliance in the opposing jaw. A retro- and prospective study. Swed Dent J. 2008;32(1):9–16.PubMedGoogle Scholar
  15. 15.
    Haviv Y, Rettman A, Aframian D, Sharav Y, Benoliel R. Myofascial pain: an open study on the pharmacotherapeutic response to stepped treatment with tricyclic antidepressants and gabapentin. J Oral Facial Pain Headache. 2015;29(2):144–51.CrossRefPubMedGoogle Scholar
  16. 16.
    Raphael KG, Marbach JJ. Widespread pain and the effectiveness of oral splints in myofascial face pain. J Am Dent Assoc. 2001;132(3):305–16.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Comprehensive DentistryUniversity of Texas Health Science Center – San AntonioSan AntonioUSA

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