What is craniomandibular dysfunction?

The symptoms

The symptoms can vary greatly in their severity and intensity. Some people have hardly any symptoms, as the jaw and chewing muscles can often adapt to changes in the dentition. Problems rarely occur as long as this adaptation is possible. Only when the load limit is exceeded does pain occur. In other patients, however, the symptoms can be severe, such as difficulty opening and closing the mouth, lockjaw or teeth grinding with damage to the tooth enamel. Headaches or tinnitus can also occur as a result of craniomandibular dysfunction.



Other names for CMD are myoarthropathy, orofacial dysfunction, mandibular dysfunction syndrome or myofascial pain syndrome. These terms refer to both the dysfunctions and their effects on the joints and muscles involved as well as the reverse effects of these on the lower jaw.

The symptoms can also occur in other areas of the body. An incorrect load in one joint can lead to pain in other areas via the nerve connections. For example, a dysfunctional temporomandibular joint can cause pain in the pelvis and, conversely, a spinal misalignment can lead to craniomandibular dysfunction.

Below you can find out all about the causes, symptoms, diagnosis and treatment of CMD.

Causes

CMD is a complex disorder that can be caused by a variety of factors. As the causes are often multifactorial, it is important to understand the various possible triggers and risk factors. Biological, psychological and social factors play a decisive role and influence the development of CMD individually for each person.

Symptoms (jaw clicking & co.)

The symptoms of craniomandibular dysfunction (CMD) are varied and can manifest themselves in different areas of the body. This wide range of symptoms often makes diagnosis complicated and requires close observation and examination by a dentist. The most common complaints include pain and restrictions in the jaw area, but other, seemingly unrelated symptoms can also occur.

How does the dentist diagnose craniomandibular dysfunction (CMD)?

The diagnosis of craniomandibular dysfunction (CMD) requires a systematic approach. Dentists proceed in several steps when diagnosing and developing a suitable treatment strategy. The first step is to find the cause or trigger of the jaw pain.

Medical history

The first step in making a diagnosis is the medical history, during which the dentist takes a detailed medical history. This involves asking about the current symptoms, duration, intensity and possible triggers. It is also important to know whether the patient has jaw, facial, neck or headaches, feels a clicking sensation in their jaw or has difficulty opening and closing their mouth. Previous treatment of the jaw or teeth, injuries to the head or neck and stress factors are also asked about.

The medical history is followed by a thorough clinical examination. The dentist checks the mobility of the jaw, the temporomandibular joints and the muscles in the head and neck area. Attention is paid to abnormalities such as sensitivity to pain, asymmetrical movements or unusual noises in the temporomandibular joint. Palpation of the masticatory muscles and surrounding structures can indicate whether there is tension or trigger points in the muscles. The dentist also examines the position of the teeth and the bite. Malpositions or disorders are detected in the process.

Clinical examination

Imaging procedures

In some cases, imaging procedures such as magnetic resonance imaging (MRI) or computer tomography (CT) are necessary for an accurate diagnosis. The temporomandibular joints and surrounding structures can be visualized in detail with these procedures. Soft tissues such as joint discs and muscles can be precisely visualized with magnetic resonance imaging. Computed tomography is particularly suitable for assessing bony structures. These imaging procedures are helpful in detecting structural changes or damage to the temporomandibular joint, which may be associated with CMD. These procedures are particularly helpful if the clinical examination and medical history do not provide clear results or if more serious problems are suspected.

Treatment planning

Following the diagnosis, the dentist draws up an individual treatment plan. This is based on the results of the medical history, clinical examination and imaging procedures. Various measures such as splint therapy, drug treatment or orthodontic measures can be included in the treatment planning. In order to ensure comprehensive treatment of CMD, interdisciplinary collaboration with other specialists may also be necessary in some cases. Treatment planning is an important step towards alleviating the patient's symptoms.

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Treatments for CMD

Treating craniomandibular dysfunction (CMD) is complex and often requires a combination of different therapies. The occlusal splint, which is often used in combination with medication, physiotherapy and psychotherapy, is a central element of treatment. 

Occlusal splint

The bite splint, also known as an occlusal splint, is one of the most common and effective methods. It is a custom-made splint, usually made of transparent plastic, which is placed on the teeth of the upper or lower jaw. Its main purpose is to separate the rows of teeth from each other. This relieves the jaw joints and chewing muscles.

The bite splint is used to stabilize the position of the jaw and correct incorrect loading. The even distribution of forces during chewing reduces pressure on the temporomandibular joints, which relieves pain and tension. The splint also prevents teeth grinding and clenching, which is a common cause of CMD. When worn at night, it can relax the muscles and promote regeneration. To achieve optimal results, the splint is worn over a longer period of time and adjusted regularly.

Medication

Medication can also be used to relieve pain and reduce inflammation. Non-steroidal anti-inflammatory drugs, which have an anti-inflammatory and analgesic effect, are frequently prescribed.

In some cases, muscle relaxants are also prescribed to relieve muscle tension. Antidepressants can be part of the drug treatment, especially if stress and psychological strain contribute to CMD. These medications help to improve general well-being.



In order to avoid side effects and interactions, it is essential that drug therapy is individually adapted and only carried out under medical supervision.

Physiotherapy

Physiotherapy includes various techniques and exercises aimed at improving jaw clicking, pain in the jaw, strengthening the muscles and relieving tension. Manual therapies, massages and special stretching exercises are among the most commonly used techniques.

The physiotherapist can also demonstrate exercises for self-treatment that can be carried out at home. The aim of these exercises is to improve the mobility of the jaw and the coordination of the muscles. Misalignments that contribute to CMD can also be corrected through physiotherapy. Significant alleviation of symptoms is only possible with regular physiotherapy.

Psychotherapy

Psychotherapy can also be an important part of treatment for craniomandibular dysfunction, as stress and psychological strain often play a role. The aim of psychotherapeutic approaches is to reduce stress and improve coping with chronic pain. Methods such as cognitive behavioral therapy (CBT) can help to identify and change negative thought and behavior patterns.

Techniques such as progressive muscle relaxation or autogenic training can also be part of the therapy. These help to reduce general tension and relax the muscles in the jaw. In some cases, biofeedback therapy can also be useful. This teaches patients to consciously control and reduce their muscle activity.

FAQ

Is CMD covered by health insurance in Switzerland?

Yes, if it is a true CMD, then this is also covered by health insurance in Switzerland. Only a competent specialist dentist can make a reliable diagnosis.