Management of temporomandibular disorders in the primary care setting

Samuel V Thambar, Sachin Kulkarni, Joshua Tesar and Scott Armstrong
Med J Aust 2021; 214 (9): . || doi: 10.5694/mja2.51044
Published online: 17 May 2021

Temporomandibular disorders (TMDs) are a major cause of orofacial pain resulting in significant morbidity and reduction in an individual’s perceived quality of life. They are a group of disorders affecting the temporomandibular joint (TMJ), masticatory muscles and surrounding structures. Up to 70% of the general population have detectable signs of TMDs, of whom only 15% are significantly affected and only 5% seek treatment, with women being twice as likely to be affected.1 Most acute articular inflammation is transient, resulting in patients not seeking treatment, and those with chronic pain tend to have acute exacerbations managed with simple conservative measures.

  • 1 Gold Coast University Hospital, Gold Coast, QLD
  • 2 Griffith University, Gold Coast, QLD
  • 3 University of Sydney, Sydney, NSW
  • 4 Princess Alexandra Hospital, Brisbane, QLD


Competing interests:

No relevant disclosures.

  • 1. Carlsson GE. Epidemiology and treatment need for temporomandibular disorders. J Orofac Pain 1999; 13: 232–237.
  • 2. Rodriguez-Lopez MJ, Fernandez-Baena M, Aldaya-Valverde C. Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation. Pain Physician 2015; 18: E229–E236.
  • 3. Guarda-Nardini L, Manfredini D, Salamone M, at al. Efficacy of botulinum toxin in treating myofascial pain in bruxers: a controlled placebo pilot study. Cranio 2008; 26: 126–135.
  • 4. Ramirez LM, Ballesteros LE, Sandoval GP. Topical review: temporomandibular disorders in an integral otic symptom model. Int J Audiol 2008; 47: 215–227.
  • 5. Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med 2008; 359: 2693–2705.
  • 6. Nagi R, Sahu S, Gahwai D, Supreet J. Study on evaluation of normal range of maximum mouth opening among Indian adults using three finger index: a descriptive study. J Indian Acad Oral Med Radiol 2017; 29: 186–190.
  • 7. Britton D, Alty JE, Mannion CJ. Oromandibular dystonia: a diagnosis not to miss. Br J Oral Maxillofac Surg 2020; 58: 520–524.
  • 8. Fonseca RJ, Marciani RD, Turvey TA. Oral and maxillofacial surgery. 2nd ed. St Louis: Elsevier, 2009: 881–897.
  • 9. Kulkarni S, Thambar S, Arora H. Evaluating the effectiveness of nonsteroidal anti-inflammatory drug(s) for relief of pain associated with temporomandibular joint disorders: a systematic review. Clin Exp Dent Res 2020; 6: 134–146.
  • 10. Rajapakse S, Ahmed N, Sidebottom AJ. Current thinking about the management of dysfunction of the temporomandibular joint: a review. Br J Oral Maxillofac Surg 2017; 55: 351–356.
  • 11. Cho SH, Whang WW. Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain 2010; 24: 152–162.
  • 12. Okeson J. Management of temporomandibular disorders and occlusion. 7th ed. St Louis: Elsevier, 2012.
  • 13. Thambar S, Kulkarni S, Armstrong S, Nikolarakos D. Botulinum toxin in the management of temporomandibular disorders: a systematic review. Br J Oral Maxillofac Surg 2020; 58: 508–519.
  • 14. Dimitroulis G. The role of surgery in the management of disorders of the temporomandibular joint: a critical review of the literature. Part 1. Int J Oral Maxillofac Surg 2005; 34: 107–113.
  • 15. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician 2015; 91: 378–386.


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