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# Temporomandibular disorder

Temporomandibular disorder is a group of problems of the jaw joint and chewing muscles, causing jaw pain, clicking and trouble opening the mouth.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [TMJ disc](https://durgical.com/en/anatomy/articular-disc-of-temporomandibular-joint/)
- [TMJ capsule](https://durgical.com/en/anatomy/temporomandibular-joint/)
- [Masseter](https://durgical.com/en/anatomy/superficial-part-of-masseter/)
- [Lateral pterygoid](https://durgical.com/en/anatomy/superior-head-of-lateral-pterygoid-muscle/)
- [Temporalis](https://durgical.com/en/anatomy/temporalis-muscle/)
- [Medial pterygoid](https://durgical.com/en/anatomy/medial-pterygoid-muscle/)
- [Mandible](https://durgical.com/en/anatomy/mandible/)
- [Temporal bones](https://durgical.com/en/anatomy/temporal-bone/)
- [Jaw ligaments](https://durgical.com/en/anatomy/sphenomandibular-ligament/)
- [V3 mandibular](https://durgical.com/en/anatomy/anterior-division-of-mandibular-nerve/)

## In embryology

- [First pharyngeal arch (mandibular arch) and the trigeminal nerve](https://durgical.com/en/embryology/first-pharyngeal-arch-and-the-trigeminal-nerve/)

## What it is

A group of painful or dysfunctional conditions of the [temporomandibular joint](https://durgical.com/en/anatomy/temporomandibular-joint/) and the chewing muscles, causing jaw pain, joint sounds and limited mouth opening.

## Who gets it

Common, especially in young and middle-aged adults; more often reported by women. Most cases are muscular and self-limiting.

## Causes

- Myofascial pain of the masticatory muscles
- Internal derangement: displacement of the articular disc
- Degenerative joint disease (osteoarthritis) or inflammatory arthritis
- Trauma to the jaw

## Risk factors

- Bruxism (teeth grinding or clenching)
- Stress, anxiety and poor sleep
- Other chronic pain conditions (headache, fibromyalgia)
- Previous jaw trauma
- Joint hypermobility

## Pathophysiology

Overload of the joint and muscles causes muscle pain and inflammation. In disc displacement the disc slips forward of the condyle: it may reduce on opening (click) or stay displaced and block opening (closed lock). Long-standing overload can lead to degenerative change of the joint surfaces.

## Classification

- Muscle disorders (myalgia, myofascial pain)
- Disc displacement with or without reduction
- Degenerative joint disease
- Criteria vary; research diagnostic criteria (DC/TMD) are widely used

## Symptoms and signs

- Pain in front of the ear, jaw or temple, worse with chewing
- Clicking or crepitus of the joint
- Limited or deviated mouth opening, or jaw locking
- Headache and ear fullness without ear disease
- Tenderness of the [masseter](https://durgical.com/en/anatomy/superficial-part-of-masseter/) and [temporalis](https://durgical.com/en/anatomy/temporalis-muscle/)

## Red flags

- Progressive trismus, numbness or a mass (consider tumour or infection)
- Fever and swelling over the joint (septic arthritis)
- Jaw claudication, scalp tenderness or visual symptoms in an older adult (giant cell arteritis)

## Diagnosis

**Clinical**
History and examination: joint palpation and sounds, mouth opening range, deviation and masticatory muscle tenderness.

**Tests**
Usually none; inflammatory markers if arteritis or inflammatory arthritis is suspected.

**Imaging**
Not needed in typical cases; MRI shows disc position, CT or cone-beam CT shows bony change.

## Differential diagnosis

- Dental pain (pulpitis, impacted wisdom tooth)
- Otitis media or externa
- Trigeminal neuralgia
- Giant cell arteritis
- Parotitis

## Goal of treatment

Reduce pain, restore jaw function and prevent recurrence, mainly with reversible conservative measures.

## Treatment

**Conservative**
Education, soft diet, jaw rest, heat or cold, and avoiding wide yawning and gum chewing.

**Rehabilitation**
Jaw exercises and physiotherapy; occlusal splints for bruxism.

**Medical**
Simple analgesics and anti-inflammatories; muscle relaxants or low-dose tricyclic agents in chronic cases.

**Procedure**
Arthrocentesis or joint injection for persistent locking or pain.

**Surgical**
Arthroscopy or open joint surgery for a small group who fail conservative care.

## Complications

- Chronic facial pain
- Persistent closed lock
- Degenerative joint change

## Prognosis

Most cases improve with conservative care within months; a minority become chronic, often alongside other pain conditions.

## Prevention

- Managing bruxism and stress
- Avoiding habitual jaw overuse

## Test yourself

Think of the answer, then tap the question to see it.

## What causes the click in a TMJ disc displacement with reduction?

The anteriorly displaced disc snapping back onto the condyle as the mouth opens.

## Which muscle pulls the disc and condyle forward on opening?

The lateral pterygoid.

## Which serious condition must be excluded in an older adult with new jaw claudication?

Giant cell arteritis.

## What is first-line management of most temporomandibular disorders?

Reversible conservative care: education, soft diet, exercises, splints and simple analgesics.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/temporomandibular-disorder/)

## Related conditions

- [Migraine](https://durgical.com/en/conditions/migraine/)
- [Acute otitis media](https://durgical.com/en/conditions/acute-otitis-media/)
- [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- [Trigeminal neuralgia](https://durgical.com/en/conditions/trigeminal-neuralgia/)
- [Giant cell arteritis](https://durgical.com/en/conditions/giant-cell-arteritis/)
- [Mandible fracture](https://durgical.com/en/conditions/mandible-fracture/)
- [Tension-type headache](https://durgical.com/en/conditions/tension-type-headache/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Temporomandibular Syndrome](https://www.ncbi.nlm.nih.gov/books/NBK551612/) (StatPearls (NCBI Bookshelf), 2023).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/temporomandibular-disorder/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/temporomandibular-disorder/