Is the Concept of Temporomandibular Joint Pain-Dysfunction Syndrome Valid?

Abstract

The concept of the temporomandibular joint (TMJ) pain-dysfunction syndrome was introduced in 1955 and subsequently underwent important changes. It purports to explain clicking, pain, and abnormal movement at the TMJ by spasm of the masticatory muscles caused by emotional disorder. The meaning of dysfunction is not agreed upon, but by any definition, the symptoms of pain and dysfunction do not characterize a syndrome distinct from structural diseases of the TMJ. The evidence adduced to show that TMJ symptoms commonly arise in the masticatory muscles, and specifically, that they are due to spasm of those muscles, does not prove these hypotheses. Neither a general nor a specific emotional basis for most cases of TMJ symptoms has been demonstrated. The concept of pain-dysfunction syndrome should be discarded, and TMJ symptoms should be ascribed to specific articular, muscular, and/or psychiatric disorders.

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Notes on contributors

Michael D. Reynolds

Michael D. Reynolds, M.D., F.A.C.P.

A 1961 graduate of Princeton University, Dr. Reynolds received his M.D. degree in 1965 from The Johns Hopkins University School of Medicine in Baltimore. From 1966 to 1968, Dr. Reynolds was a member of the medical clinic and medical-surgical team assigned to Nha-trang, Vietnam, by the United States Public Health Service. He completed an internal medicine residency at Hannemann Hospital in Philadelphia in 1970, and in 1972, he completed a two-year rheumatology fellowship at the Veterans Administration Hospital in Philadelphia.

Dr. Reynolds has served as a faculty member at the University of California, Irvine, and Howard University, where he is presently an associate professor in the College of Medicine, Department of Medicine, Washington, D.C. He also serves as staff physician for the Washington Center for Aging Services.

Dr. Reynolds is a fellow of the American College of Physicians and the American Rheumatism Association.