was devised by
Dr Stephen J Davies
BDS , M.D.Sc., D.G.D.P.(UK)
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Common Disorders

Rare disorders

Common disorders

Pain Dysfunction Syndrome

This is the most common condition suffered by patients with a temporomandibular disorder, incorporating two or more of the following signs and symptoms:

  • Pain on palpatation of the TMJ
  • Pain on palpatation of the associated muscles
  • Limitation or deviation of mandibular movement
  • Joint sounds
  • Headache (though this and joint sounds alone are not indicative of TMD)


Characterised by:

  • Joint sound due to crepitation (degeneration within surfaces of the joint or disc)
  • Limitation of jaw movement
  • Pain - usually located in the immediate pre-auricular region (not radiating to the surrounding muscles as with PDS)

Internal Derangement

Characterised by:

  • Joint click due to disc displacement or medical obstruction to mouth opening
  • Pain in later stages due to secondary muscle spasm

Trauma and dislocation

External trauma to the face and jaws can often cause mandibular or condylar fracture or more commonly traumatic arthritis, but rarely is a cause of a chronic temporomandibular disorder. In the absence of an anatomical defect, dislocation is rare and usually caused by trauma.

Treatment of the common disorders

Pain Dysfunction Syndrome, Osteoarthrosis and Internal Derangement, can and should be treated in practice. For Trauma and dislocation the patient should be referred to a specialist clinic.

Summary of Epidemiological and Patient Study Data

Age Range

15-30 for dysfunctional symptoms
40+ for degenerative joint disease
any age for internal derangement


Most common symptom

Muscle tenderness

Frequently detected

Joint noises

Clicking with dysfunctional symptoms or internal derangement
crepitus with degenerative disease

Jaw locking



Either on waking or after function