Head and Neck Manifestations of Temporomandibular Joint Disorders

  • G. Gary DemerjianEmail author
  • Anthony B. Sims
  • Mayoor Patel
  • Tammy Lee Balatgek
  • Eliseo B. SabalJr.


Many people suffering from temporomandibular joint disorders (TMD) suffer from local to distant, acute or chronic pains. This is common with people suffering from craniofacial pain, accompanied by painful and non-painful symptoms, also affecting facial muscles, cervical muscles, and the muscles of the middle ear and eyes. There are multiple anatomical and neurological possibilities, which start from the articular dysfunction of the temporomandibular joint (TMJ) that can generate many conditions.

TMD and jaw dysfunction encompass a wide range of craniofacial conditions involving the temporomandibular joint (TMJ), muscles of mastication, and the associated structures. The most common signs and symptoms of TMD are sensitivity in the muscles of the head and neck, shoulder pain or stiffness, pain in one or both joints, limited mouth opening, limited movements of the mandible, joint sounds (clicking and crackling), facial deformity, and headache. Deviation or deflection of the jaw on opening and/or closing is another factor of TMD symptoms that is not discussed much but gives great information to the clinician. Ringing in the ears, the sensation of ear fullness, earache, sensation of hypoacusis (diminished hearing), and dizziness may also be present. There are short neurons in the tegmentum, connecting the various trigeminal sensory nuclei with motor nuclei of the brainstem, including the ocular motor nuclei; the motor nuclei of the trigeminal nerve; the facial, glossopharyngeal, vagal, and hypoglossal nuclei; and the vestibular nuclei.

The goal of this chapter is to provide/explain the relationship of TMD to the common TMJ symptoms.



American College of Rheumatology


Central nervous system


Fibromyalgia syndrome


Internal derangement


National Institutes of Health


Otitis media


Patient’s global impression of change


Pittsburgh Quality of Sleep Questionnaire Index


Sleep-related bruxism


Symptom severity scale


Trigeminocervical complex


Temporomandibular joint disorder


Temporomandibular joint


Tension-type headache


Visual analogue scale


Widespread pain index


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Copyright information

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Authors and Affiliations

  • G. Gary Demerjian
    • 1
    Email author
  • Anthony B. Sims
    • 2
  • Mayoor Patel
    • 3
  • Tammy Lee Balatgek
    • 4
  • Eliseo B. SabalJr.
    • 5
  1. 1.Center for TMJ & Sleep TherapyGlendoraUSA
  2. 2.Maryland Center for Craniofacial, TMJ and Dental Sleep DisordersColumbiaUSA
  3. 3.Craniofacial Pain and Dental Sleep Center of GeorgiaAtlantaUSA
  4. 4.Center for TMJ and Sleep DisordersReadingUSA
  5. 5.Division of Oral Biology and MedicineUCLA School of DentistryLos AngelesUSA

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