Ciancaglini et al. [Citation1], in a questionnaire study in 1999, reported that the prevalence of troublesome neck pain was 47.4% in subjects with concomitant TMD symptoms versus 28.6% in subjects without (p < 0.0001). This was more prevalent in women than men and correlated significantly with face pain, jaw stiffness, and fatigue (p > 0.01). This was further supported by Grondin et al. [Citation2], who stated that there is a “direct anatomical relationship” between the muscles of the cervical spine and the temporomandibular region, the effect being a cross influence of one on the other. The seminal work of Travell and Simons [Citation3] in their 1983 book, Myofascial Pain and Dysfunction, was one of the first of its kind to shine the spotlight on this relationship, followed by many other authors [Citation4–Citation6].
Sleep factors related to pain and tension in the cervical spine and nocturnal bruxism also affect the jaw [Citation7,Citation8]. In light of the increase in dental sleep mandibular advancement devices (MADs), the importance of revisiting this relationship is vital to the further understanding of the effect of long-term overnight mandibular advancement on the temporomandibular joint tissues [Citation9], cervical musculature, and the effect on pain and airway interactions [Citation10].
The results of such future long-term studies may shed light on new interprofessional management of occlusal side effects related to the TMJs and muscle dysfunctions seen in many of our patients undergoing continuous positive airway pressure/MAD therapy.
Assessment of cervical disorders should be an integral part of a dentist’s practice in the management of temporomandibular and sleep disorders.
References
- Ciancaglini R, Testa M, Radaelli G. Association of neck pain with symptoms of temporomandibular dysfunction in the general population. Scand J Rehab Med. 1999;31:17–22.
- Grondin F, Hall T, Laurentjoye M, et al. Upper cervical range of motion is impaired in patients with temporomandibular disorders. CRANIO®. 2015 May;33(2):91–99.
- Travell J, Simons D. Myofascial pain and dysfunction: the trigger point manual. In: Travell J and Simons D.G. editors. Upper body. Vol. 1. Baltimore, MD: Williams and Wilkins; 1983. p. 15–16.
- Ceneviz C, Mehta N, Forgione A, et al. The immediate effect of changing mandibular position on the EMG activity of the masseter, temporalis, sternocleidomastoid and trapezius muscles. CRANIO®. 2006;24(4):237–244.
- Mehta N, Scrivani SJ, Maciewicz R. Dental and facial pain. In: Benson HT, Rathmell JP, Turk DC et al., editors. Raj’s practical management of pain. 4th ed. Philadelphia, PA:Elsevier; 2008:505–527.
- Sakaguchi K, Mehta N, Abdallah E, et al. Examination of the relationship between mandibular position and body posture. CRANIO®. 2007 October;25(4):237–249.
- Bader G, Lavigne G. Sleep bruxism: an overview of an oromandibular sleep movement disorder. Sleep Med Rev. 2000 February;4(1):27–43.
- Carra MC, Huynh N, Lavigne G. Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine. Dental Clin North Am. 2012;56:387–413.
- Nickel JC, Iwasaki LR, Gonzalez YM, et al. Mechanobehavior and ontogenesis of the temporomandibular joint. J Dent Res. 2018;97(11):1185–1192.
- Lobbezoo F, Thu Thon M, Remillard G, et al. Relationship between sleep, neck muscle activity and pain in cervical dystonia. Can J Neurol Sci. 1996 November;23(4):285–290.