Temporomandibular Disorder Comorbidity
Temporomandibular disorders (TMD) are conceptualized as a group of diverse conditions related to the jaw muscles, temporomandibular joint (TMJ) and related tissues and may be associated with pain, limitations in jaw movements and noises in the TMJ. It is
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Temporomandibular Disorder Comorbidity Fernando Exposto, Peter Svensson, and Lars Arendt-Nielsen
Abstract Temporomandibular disorders (TMD) are conceptualized as a group of diverse conditions related to the jaw muscles, temporomandibular joint (TMJ) and related tissues and may be associated with pain, limitations in jaw movements and noises in the TMJ. It is generally agreed that TMD just represents an umbrella term, and intensive work has been devoted to establish specific criteria for subsets of TMDs which are both reliable and valid. This has been achieved with the Diagnostic Criteria for TMD (DC/TMD) (Schiffman et al., J Oral Facial Pain Headache 28(1):6–27, 2014), and all main diagnoses now have known reliability, sensitivity and specificity values which are unique for any pain classification system. One of the new diagnoses in the DC/TMD is headache attributed to TMD (HATMD) (Schiffman et al., Cephalalgia 32(9):683–692, 2012; Schiffman et al., J Oral Facial Pain Headache 28(1):6–27, 2014) which clearly indicates that there is a close overlap between some of the many headache types and some of the painful TMDs. It may be useful from a clinical perspective to recognize some of the similarities in clinical presentation but also to try to identify potential differences in symptomatology as well as underlying pain mechanisms and management. This chapter will first provide an overview of the clinical presentations and overlaps between TMD and headache. Some of the basic mechanisms related to nociception from musculoskeletal tissues, peripheral and central sensitization and endogenous inhibitory controls will then be discussed with particular reference to TMDs.
F. Exposto Section of Orofacial Pain and Jaw Function, Institute for Odontology and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark e-mail: [email protected] P. Svensson (*) Section of Orofacial Pain and Jaw Function, Institute for Odontology and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden e-mail: [email protected] L. Arendt-Nielsen Center for Sensory-Motor Interactions, Aalborg University, Aalborg, Denmark e-mail: [email protected]
© Springer International Publishing Switzerland 2017 161 M.A. Giamberardino, P. Martelletti (eds.), Comorbidities in Headache Disorders, Headache, DOI 10.1007/978-3-319-41454-6_9
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Overview of Clinical Classifications of TMD and Headache
The international standard for headache classification is the International Classification of Headache Disorders (ICHD) which has been extensively field tested and used [1]. The DC/TMD can now be considered the international standard of clinical TMD classification together with the expanded TMD taxonomy [83]. One important point to realize is that not all TMDs are associated with pain; in fact, many of the TMDs are related to clicking or popping sounds from the TMJs or deviations in jaw movement patterns which are not painful or d
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