Temporomandibular joint dysfunction in children presenting as otalgia

Recognizing otolaryngologic symptoms in patients with temporomandibular disorders

Temporomandibular disorders (TMD) afflict millions of men, women and children. Although the management of these disorders has traditionally been the pervue of dentistry, the most common symptoms are otolaryngologic. The involvement of an otolaryngologist was important and necessary in the role of primary diagnostician and as a secondary diagnostician to rule out primary otolaryngologic disease in many of the 2,760 patients evaluated over the past 13 years. In 996 patients referred to the Center for Myofacial Pain/TMJ Therapy from the Otolaryngology Clinic of the New York Eye and Ear Infirmary, 85% complained of ear symptoms, including otalgia (64%), dizziness (42%), and muffling (30%). Sixty percent complained of throat symptoms, while headaches were reported by 81%. In 1,764 private patients evaluated for TMD, 53% were seen and/or referred by an otolaryngologist. The dentist and otolaryngologist must act as a team in recognizing and diagnosing TMD. As many of the symptoms of TMD fall within the pervue of the otolaryngologist, he or she must be cognizant of the clinical presentation of TMD. Likewise, dental practitioners must utilize the services of their medical colleagues to rule out primary otolaryngologic disorders in all patients with suspected TMD.

Temporomandibular joint noises in infants review of the literature and report of cases

Temporomandibular joint (TMJ) function and dysfunction in infants and children are poorly understood. Some reports of dysfunction in children and adolescents have appeared in the literature; however, no contemporary reports of TMJ dysfunction in infants have been published. Here we describe three cases of TMJ noises that may represent an anatomic abnormality. Patients' ages at onset were 3 days, 5 months, and 6 months. All noises occurred in the apparent absence of trauma and without other clinical findings. Two cases resolved spontaneously over a 2- to 5-month period. One case is still occurring, but the frequency is decreasing with age. In all cases there was no history of distress on the part of the child during mandibular movements or when the noises occurred. Included is a review of the literature and hypotheses of the etiology of TMJ noises in infants.