Researchers have estimated that 65%–85% of Americans experience some symptoms of temporomandibular joint dysfunction (TMD) during their lives. This is perhaps owing to the fact that the temporomandibular joint (TMJ) is the most frequently used joint in the body, moving 2000–3000 times a day. TMD is a condition that encompasses several pathologies of the jaw and the muscles of mastication (chewing). Symptoms of TMD are most common in people between 15 and 45 years of age, and are more common in women than men by a ratio of 5:1. A triad of predisposition, tissue alteration (neuromuscular, skeletal, and dental), and stress sufficient to cause jaw clenching and/or bruxism is usually necessary to provoke TMD.
Symptoms of TMD vary from case to case, but common complaints include: spasm and/or pain in the head, jaw, neck, and shoulder muscles; headaches; earaches; jaw clicking or deviation; limited jaw opening; clenching or grinding of the teeth; and dizziness. Causes can include whiplash, bruxism, malocclusion, anxiety, stress, trigger points, and postural dysfunction.
It is important for patients to seek treatment because muscle contractures may develop and degeneration of the disc, condylar head and articular eminence may occur if not corrected. There are several approaches to the treatment of TMD. These treatment strategies are as diverse as the patients presenting the symptoms. Because each patient presents differently, he or she should be assessed and treated according to his or her distinct needs. Because most of the causes and conditions associated with TMD are irremediable, it has been suggested that treatment be aimed toward symptomatic relief and not cures. Common treatment options include: splint therapy, occlusal adjustment, analgesic medications, surgery, acupuncture, trigger point injections, hydrotherapy, therapeutic ultrasound, electromyopathy, hypnorelaxation, cognitive-behavioral therapy, massage therapy, stress management, and biofeedback. Home care practices such as a soft food diet, a local application of ice, self-massage, hot showers, and stretching have also been suggested as being beneficial.
Treatments that are discussed in the dentistry literature focus on surgical repair, splint therapy, and medication. In addition, some dentists may choose to refer their patients to massage therapists to assist in treatment of this condition. Although support for the use of massage therapy as a part of a comprehensive treatment solution for TMD has been discussed, literature that addresses the effectiveness of massage therapy on TMD is limited and studies report varying degrees of success.