Temporomandibular arthralgia

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PAIN in the jaw joint is a presenting symptom of many patients who consult the maxillofacial surgeon, the otologist, or the dentist. During the years 1963 through 1965 a total of 119 patients with this symptom were examined at the Cleveland Clinic, and were given the diagnosis of temporomandibular arthralgia. This report outlines the symptoms and the signs of temporomandibular arthralgia, the methods of evaluation, and the treatment.


Earache may be the patient’s initial experience when temporomandibu-lar arthralgia is the actual problem. The auriculotemporal branch from the third (mandibular) division of the trigeminal nerve contains sensory fibers from the temporomandibular joint, the external auditory canal, and the tympanic membrane. This common nerve and the proximity of the joint, the auditory canal, and the tympanic membrane account for discomfort in the temporomandibular joint often perceived as pain in the ear.

Clicking or snapping in temporomandibular joints occurs in some patients. The sound may be so loud that it carries across a quiet room. Clicking may be transient and painless. Lancinating pain in the temporomandibular joint may be associated with joint crepitus.

Pain in a joint generally is related to motion, and this is true of pain in the temporomandibular joint. Discomfort may occur on extreme opening of the mouth; while chewing food; with clenching of the jaw and grinding of teeth (bruxism); and with mandibular movement during talking. Temporo-mandibular pain is usually one-sided, but if bilateral it is worse on one side than on the other.


The patient may. . .



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