CMD: Disorders of the Chewing Apparatus

The chewing muscles, mainly the masseter and pterygoid muscles (M. masseter, M. temporalis and the Mm. pterygoidei) can develop severe and temporarily impairing pain. Pain in the chewing muscles is about three times more common than pain in the jaw joint. The technical term for this is myofascial pain of the chewing apparatus. Myofascial pain can occur anywhere in the musculosekeletal system but is most frequently experienced along the spine (back and neck pain).

What exactly happens inside a painful muscle is not as clear as what happens inside a painful joint. It is assumed that the muscle is strained as a result of too much repeated stress being put on it. As a result, the muscle is not properly nourished and becomes shortened and hardened. Muscle pain is generally felt as a dull, pulling pain.

It is not easy to identify the source of the pain and it tends to spread to neighbouring structures (referred pain). So, pain in the chewing apparatus can, for example, spread to the jaw and the teeth and could then be mistaken for toothache. If diagnosed incorrectly, such a situation could lead to teeth being extracted unnecessarily, which amounts to serious medical malpractice.

Fortunately, pain in the chewing apparatus is usually nothing serious and is generally self-limiting, which means that it normally gets better on its own without any treatment. Any need for treatment is therefore based entirely on the wishes of the patient. Appropriate therapy measures are medical information, relaxation exercises, behavioral therapy, an occlusal splint worn at night and physiotherapy.