Temporomandibular Disorder

Temporomandibular disorder refers to non-specific diagnoses characterized by pain and dysfunction of the temporomandibular joint (TMJ) and the muscles of mastication. Epidemiological studies show that approximately 10% of the global population suffers from this condition. The condition peaks at around 20 to 40 years old but is more prevalent in women above 30 years old (Wu et al., 2017; Gauer & Semidey, 2015). Temporomandibular joint is classified as extra-articular and intra-articular, or soft-tissue and hard joint tissue disorders (Gauer & Semidey, 2015; Zhu et al., 2019). Although the etiology of TMD is hard to identify, some studies posit that it is multifactorial, meaning that it involves different factors. These include myofascial pain syndrome (the leading cause), psychological stress, occlusal abnormalities, poor nutrition and oral health, joint laxity, and orthodontic treatment (Gauer & Semidey, 2015). Patients with TMD present with TMJ clicking, acute or chronic myofascial pain, tenderness and pain of the mastication muscles, and abnormal jaw movements (Zhu et al., 2019). Other symptoms include pain when chewing, tinnitus, headache, neck pain, and impairments in hearing and balance. The TMJ clicking signifies a problem with the joint, which rarely happens (Zhu et al., 2019). All symptoms that last for more than a week should be evaluated by a dentist, who identifies the cause and recommends the appropriate management.

There is no agreement on the appropriate management for TMJ pain since TMD has a multifactorial nature. Most common treatment strategies include pharmacotherapy, physical therapy, psychological and cognitive-behavioral therapies, surgical procedures, occlusal therapy, biofeedback, and acupuncture (Wu et al., 2017; Gauer & Semidey, 2015). The management of TMJ pain targets muscle relaxation, joint massage, resting, and removal of causes of increased joint burden (Zhu et al., 2019). Acupuncture has been used in traditional Chinese medicine to achieve muscle relaxation, treat TMJ lesions, and relieve TMJ pain. Acupuncture involves inserting acupuncture needles on acupuncture points at appropriate depths to stimulate blood flow and energies around the meridians (Zhu et al., 2019). The sessions last from 15 to 30 minutes, and the average required number is six to eight (Gauer & Semidey, 2015). However, the response to therapy depends on the history and presentation of the disease. For instance, acute pain requires a shorter duration to manage, unlike chronic cases (Zhu et al., 2019). Traditional Chinese medicine posits that toothaches occur when the essential energy in the meridians of the stomach and intestines remain inactive. This stagnation inhibits the energy from flowing directly to the lower and upper plates. Acupuncture pins are pushed around the ear and jaw or other painful areas. The pins can also be inserted near the elbows, big toe, and knees since they share common paths between the meridians. Balancing the energy in the meridians helps relieve stress and other factors that may cause TMJ discomfort (Zhu et al., 2019).

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