1050 D3000 new imprint Word template Vol 13, No 1 (2025) ISSN 2167-8677 (online) DOI 10.5195/d3000.2025.1050 http://dentistry3000.pitt.edu Analysis of Different Symptoms Associated with Temporomandibular Joint Complaints Natheer Ayed Jassem College of Den*stry, Al-Bayan University, Baghdad, Iraq Abstract Objec2ve: To determine the frequency of symptoms of paKents who have TMJ discomfort. Materials and Methods: An electronic quesKonnaire in the Google plaSorm and distributed to people with temporomandibular joint disease. Results: 420 responses were obtained. 312 people indicated they were tense or nervous and 219 people answered they had headache, and 207 indicated having a problem in the joints. 183 people answered they heard noises in their TMJ while chewing or opening their mouth. 78 paKents followed up their symptoms for further invesKgaKon and treatment. Conclusion: A high frequency of individuals experiences TMD symptoms. Open Access Cita%on: Jassem NA. (2025) Analysis of Different Symp- toms Associated with Temporomandibular Joint Com- plaints. Den%stry 3000. 1:a001 doi:10.5195/d3000.2025.1050 Received: September 18, 2025 Accepted: September 24, 2025 Published: October 15, 2025 Copyright: ©2025 Jassem NA. This is an open access ar- %cle licensed under a Crea%ve Commons ASribu%on Work 4.0 United States License. Email: natheer.ayed@albayan.edu.iq Introduc)on The Temporomandibular Joint (TMJ) is amongst most complex, fragile and fre- quently used joints in the body, connecting the jaw to the skull via muscles, ligaments and tendons. The temporomandibular joint is very susceptible to abnormalities or disor- ders due to its unique anatomical and func- tional relationship with the masticatory muscles and ligaments. The term “temporo- mandibular disorders” (TMD) refers to a va- riety of medical conditions that affect the oral muscles and/or joints and tissues. TMD is more frequently occur in female than male and occurs most often in adults between the ages of 20 and 40. TMD shares symptoms with many other chronic conditions. Prob- lems with the functioning of the activity of this system explain complexity of the system itself. Although many treatments are recom- mended, a multidisciplinary team is still nec- essary because TMD is a complex disease. Temporomandibular disorders (TMD) typi- cally manifest through a wide range of symp- toms, such as pain, limited jaw movement, abnormal joint sounds, and functional difLi- culties including problems with chewing and speaking. These are frequently associated with psychological disturbances. The most prevalent types of temporoman- dibular disorders have complicated and mainly unresolved etiologies. Although psy- chogenic factors have been mentioned, they are frequently viewed as aggravating rather than causative factors for temporomandibu- lar disorders, like trauma and malocclusion. As a result, it has been hypothesized that only a subset of patients who are predis- posed to temporomandibular disorders will experience pain and dysfunction after an ag- gravating event like a recent physical or psy- chological trauma. This raises the possibility of an underlying genetic predisposition to TMD, though this remains a mystery [1-3]. Patients with temporomandibular disorders frequently report a variety of nonspeciLic symptoms, including headaches, earaches, tinnitus, neck, and shoulder pains; however, since these symptoms are not thought to be speciLically diagnostic for temporomandibu- lar disorders, other causes should be looked for and ruled out [4,5]. TMD treatment depends on a proper diagno- sis, which in turn needs the patient's medical history, a clinical examination, and the right investigations to add to the information needed to conLirm the diagnosis [1]. Orofacial pain, joint noises, limited mouth opening, or a mix of these, along with other less speciLic issues like headache and tinni- tus, may be the main complaint. It is im- portant to consider how the pain interacts with other characteristics like joint noise and limited mandibular movements. Pain should be carefully assessed in terms of its onset, nature, intensity, site, duration, aggravating and relieving factors, and more. Additionally, Analysis of Different Symptoms Associated with Temporomandibular Joint Complaints Vol 13, No 1 (2025) DOI 10.5195/d3000.2025.1050 http://dentistry3000.pitt.edu 2 during the consultation, it is necessary to conLirm any underlying factors like stress, anxiety, depression, or a major life event to develop a better picture of the psychogenic basis of the temporomandibular disorder. In general, the likelihood that a patient will re- act favorably to additional treatment de- creases with the length of the symptoms and the number of treatments, particularly "failed treatments," unless a psychogenic cause can be identiLied [5,6]. TMD classiLica- tion can be generally divided into two cate- gories: extra-articular (affecting the sur- rounding tissues) and intra-articular (occur- ring within the joint) [7]. The patients with TMDs often have onset of their symptoms during periods of psycholog- ical stress (i.e., anxiety) and exacerbation of symptoms during periods of stressful situ- ations. Myofacial pain is a symptom usually precipitated by stress and is usually noticed aggravated during the exams period among the University students [8]. Temporomandibular joint (TMJ) clicking was the most common indication and symp- tom of TMJ dysfunction 73.6%, followed by TMJ pain 71.8%, Headache 59.4%, Bruxism 51.3%, Deviation 29.1%, Trismus 22.6% and the least one is Dislocation 12.3% however, no signiLicant difference between females and males, while there was signiLicant differ- ence with deviation and highly signiLicant difference with headache between females and males [9]. Materials and Methods An electronic questionnaire was conducted on the Google platform. The questionnaire was circulated on 21/2/2024. All people spoke Arabic. 420 responses were obtained and partici- pants ranged from 20 to 60 years of age. Results Table 1 summarizes the frequency of an- swers. 312 people answered they were tense or nervous. 219 people answered yes for headache and 207 had problem in the joints. 183 people said yes for noise in their TMJ while chewing or opening their mouth. 78 patients chose to follow up for further inves- tigation and treatment. Discussion We found the biggest number of patients considered themselves nervous and this agrees with previous work [10]. When TMD and headache occur together [11], the treatment of one may have a bene- Licial therapeutic effect on the other as well. From the 78 patients who came to teaching clinic for follow up, 42 patients had head- aches, and 3 patients had been diagnosed previously with migraines and were under medication. Malocclusion is also associated with TMD [12]. 60% of the respondents vis- ited the clinic for orthodontic treatment. We found that 39.3 of responders had pain and previous work showed that 59.09% of patients have pain [13]. Neck pain was found in 38.3% of the responders in this study and previous work [14] showed a higher fre- quency (70%). Ethical Approval Scientific research ethics committee of Al- Bayan Dentistry College 2023- 0S003/21/9/2023. Conflict of Interest None. Data Availability The raw data collected by the researcher from which the statistical analysis obtained was saved completely and can be forward at any time under your request. Funding None. References 1. Ahmad M, Schiffman EL. Temporoman- dibular joint disorders and orofacial pain. Dental Clinics. 2016 Jan 1;60(1):105-24. https://doi.org/10.1016/j.cden.2015.08.004 2. Glaros AG, Marszalek JM, Williams KB. Longitudinal multilevel modeling of facial pain, muscle tension, and stress. Journal of dental re- search. 2016 Apr;95(4):416-22. https://doi.org/10.1177/0022034515625216 3. Ghurye S, McMillan R. Pain-related tem- poromandibular disorder–current perspectives and evidence-based management. Dental update. 2015 Jul 2;42(6):533-46. https://doi.org/10.12968/denu.2015.42.6.533 4. Forssell H, Kotiranta U, Kauko T, Su- vinen T. Explanatory models of illness and treat- ment goals in temporomandibular disorder pain patients reporting different levels of pain-related disability. J Oral Facial Pain Headache. 2016 Jan 1;30(1):14-20. doi: 10.11607/ofph.1482 5. Graff-Radford SB, Abbott JJ. Temporo- mandibular disorders and headache. Oral and Maxillofacial Surgery Clinics. 2016 Aug1;28(3):335-49. https://doi.org/10.1016/j.coms.2016.03.004 6. Ismail F, Eisenburger M, Lange K, Schneller T, Schwabe L, Strempel J, Stiesch M. Identibication of psychological comorbidity in TMD-patients. CRANIO®. 2016 May 3;34(3):182- 7. https://doi.org/10.1179/2151090315Y.0000000 008 7. Gopi I, Muthukrishnan A, Mara- gathavalli G. Clinical Practice Guidelines for the Management of Temporomandibular Joint Disor- ders--A Review. Journal of Evolution of Medical and Dental Sciences. 2021 Aug 16;10(33):2809- 16. 8. Hasan RM, Ahmed JN. Determination of the effect of stress on the salivary cortisol level among sample university students having myofa- cial pain. Journal of Baghdad College of dentistry. 2013;25(3):87-90. 9. Hasan RM, Diajil AR, Ali NM, Aswad F, Tariq LZ. Clinical characteristics of temporoman- dibular disorders in a sample of Iraqi patients. Wi- adomości Lekarskie has been published since 1928. 2025;78(1):143-7. doi: 10.36740/WLek/197186 10. Santos EA, Peinado BR, Frazao DR, Né YG, Fagundes NC, Magno MB, Maia LC, Lima RR, Souza-Rodrigues RD. Association between tem- poromandibular disorders and anxiety: A system- atic review. Frontiers in Psychiatry. 2022 Oct 13;13:990430. doi: 10.3389/fpsyt.2022.990430 11. Yakkaphan P, Smith JG, Chana P, Renton T, Lambru G. Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports. 2022 May 16;5:25158163221097352. https://doi.org/10.1177/25158163221097352 12. Rustam G. Correlation Between Tem- poromandibular Disorders and Malocclusions: A Retrospective Observational Study - Can Malocclu- sions or Previous Orthodontic Treatments Affect Temporomandibular Disorders? HI OHI-S, 36 min de lectura24 julio 2023. 13. Sanchla AD, Shrivastav S, Bharti L, Kam- ble R, Shrivastav Sr S. Comparative evaluation and correlation of pain pattern in neck musculature observed in mild, moderate, and severe temporo- mandibular joint disorder cases as compared to non-temporomandibular joint disorder cases. Cu- reus. 2022 Oct 9;14(10). doi: 10.7759/cu- reus.30099 14. Alana B. Neck pain and TMJ disorders: Are they related? 2023. ttps://www.medicalnew- stoday.com/articles/can-tmj-cause-neck-pain. Analysis of Different Symptoms Associated with Temporomandibular Joint Complaints Vol 13, No 1 (2025) DOI 10.5195/d3000.2025.1050 http://dentistry3000.pitt.edu 3 Table 1. Questionnaire used. Questionnaire questions No (%) Yes (%) Do you have difLiculty in opening your mouth wide? 78.6 21.4 Do you have difLiculty moving your jaws to the sides? 85.6 14.4 Do you feel tired/ have muscle pain when you chew? 60.7 39.3 Do you have frequent headaches? 47.8 52.1 Do you have neck pain / stiff neck? 61.2 38.3 Do you have earaches or pain in that area (TMJ)? 68.8 31.2 Have you ever noticed any noise in your TMJ while chewing or opening your mouth? 56.4 43.6 Do you have any habits such as clenching/grinding your teeth? 66.4 33.6 Do you feel that your teeth do not articulate well? 50.7 49.28 Do you consider yourself a tense (nervous person)? 25.7 74.2