Pathophysiology of TMD pain--basic mechanisms and their implications for pharmacotherapy.

  • Cairns B
  • 56

    Readers

    Mendeley users who have this article in their library.
  • N/A

    Citations

    Citations of this article.

Abstract

This article discusses the pathophysiology of temporomandibular disorders (TMD)-related pain and its treatment with analgesic drugs. Temporomandibular disorders are comprised of a group of conditions that result in temporomandibular joint pain (arthralgia, arthritis) and/or masticatory muscle pain (myofascial TMD). In at least some patients with TMD, a peripheral mechanism contributes to this pain. However, there is often a poor correlation between the severity of TMD-related pain complaints and evidence of definitive tissue pathology. This has led to the concept that pain in some patients with TMD may result from altered central nervous system pain processing and further that this altered pain processing may be attributable to specific genes that are heritable. Psychosocial stressors are also thought to contribute to the development of TMD-related pain, particularly masticatory muscle pain. Finally, substantially more women suffer from TMD than men. Although there are arguably multiple reasons for sex-related differences in the prevalence of TMD, one candidate for the increased occurrence of this disorder in women has been suggested to be the female sex hormone oestrogen. Analgesic drugs are an integral part of the primary treatment for TMD-related pain and dysfunction with more that 90% of treatment recommendations involving use of medications. The most commonly used agents include non-steroidal anti-inflammatory drugs, corticosteroids, muscle relaxants, anxiolytics, opiates and tricyclic antidepressants, however, evidence in support of the effectiveness of these drugs is lacking. Continued research into the pathophysiology of TMD-related pain and the effectiveness of analgesic treatments for this pain is required.

Author-supplied keywords

  • Analgesics
  • Analgesics: therapeutic use
  • Facial Pain
  • Facial Pain: drug therapy
  • Facial Pain: genetics
  • Facial Pain: physiopathology
  • Facial Pain: psychology
  • Female
  • Gonadal Steroid Hormones
  • Gonadal Steroid Hormones: physiology
  • Humans
  • Male
  • Pain Measurement
  • Psychological
  • Psychological: physiopathology
  • Risk Factors
  • Sex Factors
  • Stress
  • Temporomandibular Joint Dysfunction Syndrome
  • Temporomandibular Joint Dysfunction Syndrome: drug
  • Temporomandibular Joint Dysfunction Syndrome: gene
  • Temporomandibular Joint Dysfunction Syndrome: phys
  • Temporomandibular Joint Dysfunction Syndrome: psyc

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Authors

  • B E Cairns

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free