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Am Fam Physician. 2023;107(1):52-58

Patient information: See related handout on temporomandibular disorders.

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Temporomandibular disorders affect between 5% and 12% of the population and present with symptoms such as headache, bruxism, pain at the temporomandibular joint, jaw popping or clicking, neck pain, tinnitus, dizziness, decreased hearing, and hyperacuity to sound. Common signs on physical examination include tenderness of the pterygoid muscles, temporomandibular joints, and temporalis muscles, and malocclusion of the jaw and crepitus. The diagnosis is based on history and physical examination; however, use of computed tomography or magnetic resonance imaging is recommended if the diagnosis is in doubt. Nonpharmacologic therapy includes patient education (e.g., good sleep hygiene, soft food diet) and physical therapy. Pharmacologic therapy includes nonsteroidal anti-inflammatory drugs, cyclobenzaprine, tricyclic antidepressants, and gabapentin. Injections of the temporomandibular joints with sodium hyaluronate, platelet-rich plasma, and dextrose prolotherapy may be considered, but the evidence of benefit is weak. A referral to oral and maxillofacial surgery is indicated for refractory cases.

Temporomandibular disorders (TMDs) include conditions that cause pain or dysfunction with the muscles of mastication or the temporomandibular joint (TMJ). This rapid evidence review focuses on patient-oriented evidence for managing patients with issues related to the temporomandibular region.

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