Temporomandibular Joint Disorders in the Elderly
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 broader group of musculoskeletal disorders, due to the similarities with conditions affecting other body districts.
The prevalence of TMD signs and symptoms in the general population is high and ranges from 16 to 88%, even if treatment is needed only by a minority of subjects. This observation supports the claim that TMDs are generally self-limiting and the progression toward chronic and disabling forms is uncommon. Notwithstanding that, about one tenth of individuals with TMD develops disabling chronic pain, thus requiring a multidisciplinary approach also addressing the psychosocial component of the disease.
Epidemiological data suggest that the age distribution of TMD diagnoses in patients’ populations is quite peculiar, with two distinct age peaks: one at about the age of 30–35 years for subjects mainly complaining of TMJ disk displacements with or without pain and one at about the age of 50–55 years for subjects with degenerative joint disorders. Such observation may appear obvious at first glance, but it was described only recently, since a mean age of about 40 years was usually described for TMD populations as a whole. Thus, while the term “temporomandibular disorders” groups together with some different pathologies featuring common clusters of symptoms, getting deeper into the epidemiology of the different TMD diagnostic groups is fundamental for an improvement of knowledge in this field.
Based on these premises, this chapter will overview some general concepts of TMD etiology, diagnosis, and management for the general practitioners and will then focus on the main issues concerning the clinical and imaging picture of TMJ disorders in the elderly.