Severity of Temporomandibular Joint Disorder Among Patients Presenting to Tertiary Care Hospital

Abstract

Temporomandibular joint disorders (TMDs) comprise a group of musculoskeletal conditions affecting the temporomandibular joint, masticatory muscles, and associated structures. These disorders can result in pain, joint sounds, restricted jaw movement, and functional impairment, significantly affecting quality of life. Assessing the severity of TMD is important for early diagnosis and appropriate management. Objective: To determine the severity of temporomandibular joint disorder among patients presenting to a tertiary care hospital. Methods: This cross-sectional study was conducted on 145 patients aged 18–60 years of either gender presenting with symptoms suggestive of temporomandibular joint disorder, including aching pain in or around the ear, difficulty or pain during chewing, joint locking, and jaw tenderness at department of Oral and Maxillofacial Surgery Department, Rehman Medical Institute, Peshawar from 28-February-2025 to 28-May-2025. Patients with a history of temporomandibular joint pathology, ear disease, orthodontic treatment, dental fillings, or facial trauma were excluded. The severity of TMD was assessed using the Fonseca Anamnestic Questionnaire. Clinical manifestations, including temporomandibular joint pain, clicking, tenderness, pain during eating, headache, and earache, were recorded. Data were analyzed using SPSS version 21. Descriptive statistics were calculated, and associations between clinical features and TMD severity were evaluated using appropriate statistical tests, with a p-value <0.05 considered statistically significant. Results: The mean age of the participants was 37.72 ± 12.54 years. There were 82 (56.6%) males and 63 (43.4%) females. Based on Fonseca's classification, 72 (49.7%) patients had no TMD, 44 (30.3%) had mild TMD, 25 (17.2%) had moderate TMD, and 4 (2.8%) had severe TMD. Overall, TMD was identified in 73 (50.3%) patients. Temporomandibular joint pain was present in 32 (22.1%) patients and showed a significant association with increasing TMD severity (p < 0.001). Joint clicking was observed in 40 (27.6%) patients and was also significantly associated with greater TMD severity (p = 0.022). Conclusion: Temporomandibular joint disorder was observed in approximately half of the study population, with mild TMD being the most common presentation. Temporomandibular joint pain and clicking were significantly associated with increasing disease severity. Early recognition of these clinical features may facilitate timely diagnosis and management of TMD.