The TMJ Troubles and Their Nutritional Consequences

The term temporomandibular disorder (TMD) refers to a heterogeneous group of pathologies affecting the stomatognathic system, characterized by pain and functional limitation within the temporomandibular joint (TMJ) area, the muscles of mastication, and the related structures. TMDs are considered the most common cause of orofacial pain of nondental origin and are currently included within the musculoskeletal disorders. They are characterized by a classically described triad of clinical signs: muscle and/or TMJ pain; TMJ sounds; and restriction, deviation, or deflection of the mouth opening path. TMD symptoms have always been considered to have a broad prevalence peak between 20 and 40 years of age, with a lower prevalence in younger and older people. For specific TMD conditions, distinct peaks were recently identified in patient populations: one around the age of 30 years for subjects with disc displacements and another over the age of 50 years for inflammatory-degenerative joint disorders. The etiology of TMD is complex, multifactorial and consistent with the biopsychosocial model of illness. Negative emotional states such as depression and anxiety are known contributing factors to TMD. Clinical studies agree that chronic medical conditions have strong negative effects on quality of life. TMD that run a chronic course are more likely associated with psychological and somatic complaints as well as sleep disturbances. Stressful and dynamic academic, work or family environments can also sufficiently. The most common symptoms observed in patients with temporomandibular disorders are: chronic pain; loss of energy; activity restriction (inability) of physical ailments and emotional disorders; emotional state; general health problems; anxiety/depression; voice changes; taste changes, discomfort when eating, owing to limited mandibular opening and pain and discomfort with biting and chewing. Consequently, painful TMD may affect dietary intake and nutritional status. Management of painful TMD is multifaceted and involves pharmacologic, physical, and cognitive behavior and dietary therapies. There is a lack of evidence‐based dietary guidelines for patients that clinicians can use to assess and manage diet and nutritional well-being in patients with this disorder. The Author presents recommendations to guide clinicians on how to help the neglected patients with painful TMD improve the quality of their diets and avoid or minimize eating-related pain. The areas of discussion will include reviewing the following: potential impact of painful TMD on eating and nutritional status; potential role of diet and nutrition in the TMD management; and dietary guidance for patients with TMD.