TMJ, TMD, Headaches and Fibromyalgia: Is Neuromuscular Dentistry a Cure?

A recent article in the Journal of Craniofacial Surgery ties symptoms of TMJ disorders and Fibromyalgia. The article suggests that "the need for an integrated diagnosis and treatment of these patients, which suggest that the FM could be a medium- or long-term risk factor for the development of TMD." What is also known is that Fibromyalgia is frequently related a sleep disorders.

The National Heart Lung and Blood Institue of the NIH published a report that considers Sleep apnea to be a TMJ disorder. The paper "Cardiovascular and Sleep Related Consequences of Temporomandibular Disorders" suggests that fibromyalgia may actuallly be a consequence of TMJ disorders. While Fibromyalgia is often difficult to treat the TMJ and Headache component is usually very responsive to Neuromuscular Dental Treatment. It is not uncommon to see many other fibromyalgia symptoms self correct after treatment of the TMD and Jaw muscular components.

I suggest that all Fibromyalgia patients should be fitted with Diagnostic Neuromuscular Orthotics as an integral part of the diagnostic and treatment sequences. Patients report signifcant and often life changing symptom reduction after reversible treatment with a neuromuscular diagnostic orthotic.

J Craniofac Surg. 2012 Mar;23(2):615-8.

Signs and symptoms of temporomandibular dysfunction in fibromyalgic patients.

Fraga BP, Santos EB, Farias Neto JP, Macieira JC, Quintans LJ Jr, Onofre AS, De Santana JM, Martins-Filho PR, Bonjardim LR.

Source

From the *Health Science, Federal University of Sergipe, Aracaju, Sergipe; †Department of Nursing, University of São Paulo, São Paulo; and Departments of ‡Physical Therapy, §Medicine, and ∥Physiology, Federal University of Sergipe, Aracaju, Sergipe, Brazil.

Abstract

OBJECTIVE:

The objective of this study was to determine the frequency of signs and symptoms of temporomandibular disorder (TMD) in fibromyalgic patients.

METHODS:

Sixty subjects of both sexes (mean age, 49.2 ± 13.8 years) with fibromyalgia (FM) diagnosis were included in this study. All patients were examined by a calibrated investigator to identify the presence of TMD using the Research Diagnostic Criteria for TMD.

RESULTS:

The most common signs (A) and symptoms (B) reported by FM patients were (A) pain in the masticatory muscles (masseter, 80%; posterior digastric, 76.7%), pain in the temporomandibular joint (83.3%), and 33.3% and 28.3%, respectively, presented joint sounds when opening and closing the mouth; (B) headache (97%) and facial pain (81.7%). In regard to the classic triad for the diagnosis of the TMD, it was found that 35% of the FM patients presented, at the same time, pain, joint sounds, and alteration of the mandibular movements. It was verified that myofascial pain without limitation of mouth opening was the most prevalent diagnosis (47%) for the RDC subgroup I. For the subgroup II, the disk displacement with reduction was the most prevalent diagnosis (21.6%). For the subgroup III, 36.7% of the subjects presented osteoarthritis.

CONCLUSIONS:

Thus, there is a high prevalence of signs and symptoms of TMD in FM patients, indicating the need for an integrated diagnosis and treatment of these patients, which suggest that the FM could be a medium- or long-term risk factor for the development of TMD.