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Billing TMD, Never forget that patients have a function issue and more then one reason for treatment. Use more then one diagnostic reason.

R13.11 – Dysphagia, oral phase
Swallowing Changes Related to Chronic Temporomandibular Disorders

Fassicollo, Carlos & Machado, Barbara & Garcia, Denny & de Felício, Cláudia Maria. (2018). Swallowing changes related to chronic temporomandibular disorders. Clinical Oral Investigations. 10.1007/s00784-018-2760-z.


Objectives: To investigate whether chronic temporomandibular disorder (TMD) patients showed any changes in swallowing compared to a control group. Moreover, it was examined whether swallowing variables and a valid clinic measure of orofacial myofunctional status were associated.

Material and methods: Twenty-three patients with chronic TMD, diagnosed with disc displacement with reduction (DDR) and pain, according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and 27 healthy volunteers (control group) were compared. Surface electromyography (EMG) of the temporalis, masseter, sternocleidomastoid, and suprahyoid muscles was performed during swallowing tasks of thin liquid (10 and 15 mL) and spontaneous saliva. Data were normalized.

Results: Compared to the control group, TMD patients showed a prolonged duration of swallowing for liquid and saliva and required a longer time to reach the activity peak and half the integral. While the overall mean value of the relative peaks was similar for the groups, the suprahyoid peak was significantly lower in the TMD group during swallowing of liquid. Moreover, TMD patients recruited the jaw elevator muscles proportionally more than controls. The orofacial myofunctional status was moderately correlated with EMG parameters.

Conclusion: Patients with chronic TMD showed temporal prolongation and changes in the relative activity of the muscles during the swallowing tasks.

Clinical relevance: The present results contribute additional evidence regarding the reorganization of muscle activity in patients with chronic TMD.

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