The Prevalence, Nature, and Management of Oral Stage Dysphagia in Adults with Temporomandibular Joint Disorders: Findings from an Irish Cohort

Abstract

Purpose: Temporomandibular disorders (TMDs) are caused by changes in the structure and/or function of the temporomandibular joint, masticatory muscles, and/or osseous components. TMDs may result in oral stage dysphagia (OD) with potential effects on function and patient well-being. Little is known about the prevalence, nature, and management of TMD-related OD. The aims of this study were to estimate the prevalence and nature of OD in adult TMD patients, and to identify common management techniques used to manage the signs and symptoms of TMD-related OD. Methods: An 18-item subjective questionnaire was adapted from existing tools and used to investigate TMD aetiology, symptoms, and signs of TMD-related OD, and intervention techniques employed to manage these symptoms. This was disseminated to 178 TMD patients consecutively recruited over 6-months in 2016. Descriptive and statistical methods were used to analyse the data. Results: Ninety nine percent of TMD participants reported at least one symptom/sign of OD. Individuals presenting with subluxation of the jaw (80%), degenerative joint disorder (67%), and myofascial pain disorder (40%) reported OD most frequently. Common symptoms included painful mastication (90%), masticatory fatigue (78%), difficulties swallowing (33%), and difficulties drinking liquids (28%). Use of a broad range of management techniques was reported, with these including both OD-specific (e.g.: diet modifications (81%)), and non-OD specific techniques (e.g: analgesia (79%) and oral splints (75%)). Conclusion: OD is prevalent and difficulties with mastication are common in TMDs. Interventions employed were diverse, with varying objectives and disparate levels of evidence supporting their efficacy within this cohort. Further research should address the epidemiology of TMD-related OD, evidence-based interventions, and the promotion of collaboration across disciplines responsible for managing TMD-related OD (e.g.: speech and language therapy, oral and maxillofacial surgery, dentistry, restorative dentistry, orthodontics, oral medicine etc.).