Oromandibular dystonia and temporomandibular disorders

Background. The aim of this study was to characterize clinical features of patients with oro-mandibular dystonia (OMD) who had temporomandibular disorder (TMD) symptoms. Methods. A retrospective chart review of patients seeking treatment at a tertiary-level orofacial pain clinic from January 2015 through December 2020 was undertaken. The inclusionary criteria consisted of a diagnosis of OMD (International Classification of Diseases, Revision 10 code G24.4), which had been confirmed by a neurologist. Results. Eleven patients met the inclusion criteria. Focal dystonia and jaw deviation OMD were the most frequent diagnoses. A dental procedure was a triggering or aggravating factor in 36.4% of patients. All but 2 patients had a sensory trick, or tactile stimulus to a particular body part, and approximately one-half of the patients used an oral appliance as a sensory trick device. All but 1 patient had received a diagnosis of TMD, with myofascial pain of the masticatory muscles being the most prevalent diagnosis. Four patients had received a recommendation for orthodontic treatment. About one-half of the patients had undergone 1 or more invasive dental or maxillofacial surgical interventions to address their dystonia. Anxiety was the most common psychological comorbidity. Conclusions. Because patients with OMD commonly experience TMD symptoms, they can receive a misdiagnosis of TMD while the OMD is overlooked. Practical Implications. Owing to concomitant TMD symptoms, patients most often seek dental consultations and undergo treatments such as orthodontic interventions and temporomandibular joint surgeries. A dentist's competency in recognizing these patients can prevent unnecessary procedures and facilitate appropriate patient care.

Automated summary

This study aimed to characterize the clinical features of patients with oro-mandibular dystonia (OMD) who presented with temporomandibular disorder (TMD) symptoms. The results showed that focal dystonia and jaw deviation were the most frequent diagnoses among OMD patients. Dental procedures were found to trigger or worsen symptoms in approximately 36.4% of patients. Nearly all patients had a sensory trick, with approximately half of them using an oral appliance as a sensory trick device. The majority of patients had received a diagnosis of TMD, with myofascial pain of the masticatory muscles being the most prevalent diagnosis. Anxiety was the most common psychological comorbidity.