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Oromandibular dystonia and temporomandibular disorders

by adminjay


The aim of this study was to characterize clinical features of patients with oromandibular
dystonia (OMD) who had temporomandibular disorder (TMD) symptoms.


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.


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


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.

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