Editing Temporomandibular joint dysfunction (section)

==Signs and symptoms==
Signs and symptoms of temporomandibular joint disorder vary in their presentation. The symptoms will usually involve more than one of the various components of the masticatory system, [[muscle]]s, [[nerves]], [[tendons]], [[ligaments]], [[bone]]s, [[connective tissue]], or the [[teeth]].<ref name="Okeson 2003">{{cite book |last=Okeson |first=Jeffrey P. | name-list-style = vanc |title=Management of temporomandibular disorders and occlusion |year=2003 |publisher=Mosby |location=St. Louis, Missouri |isbn=978-0-323-01477-9 |edition=5th |pages=191, 204, 233, 234, 227}}</ref>

The three classically described, cardinal signs and symptoms of TMD are:<ref name="Manfredini 2011">{{cite journal |vauthors = Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F | title = Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings |journal = Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics |volume = 112 |issue = 4 |pages = 453–62 |date = October 2011 |pmid = 21835653 |doi = 10.1016/j.tripleo.2011.04.021 |url = http://lucaguarda.it/articoli/140.pdf }}</ref><ref name="Wright 2010" />
# Pain and tenderness on [[palpation]]<!-- <ref name="Al-Ani 2004" /> --> in the muscles of mastication,<!-- <ref name="Mujakperuo 2010" />  --> or of the joint itself (preauricular pain – pain felt just in front of the ear).<!-- <ref name="Mujakperuo 2010" />  --> Pain is the defining feature of TMD<!-- <ref name="Mujakperuo 2010" />  --> and is usually aggravated by manipulation or function,<ref name="Mujakperuo 2010" /> such as when chewing, clenching,<ref name="Neville 2001" /> or yawning,<!-- <ref name="Classification of Chronic Pain" /> --> and is often worse upon waking.<!-- <ref name="Classification of Chronic Pain" /> --> The character of the pain is usually dull or aching, poorly localized,<ref name="Cairns 2010" /> and intermittent, although it can sometimes be constant.<!-- <ref name="Classification of Chronic Pain" /> --> The pain is more usually unilateral (located on one side) rather than bilateral.<ref name="Classification of Chronic Pain" /> It is rarely severe.<ref name="Cawson 2002" /> 
# Limited range of mandibular movement,<ref name="Mujakperuo 2010" /> which may cause difficulty eating or even talking.<!-- <ref name="Wassell 2008" />  --> There may be locking of the jaw,<!-- <ref name="Wassell 2008" />  --> or stiffness in the jaw muscles and the joints, especially present upon waking.<ref name="Wassell 2008" /> There may also be incoordination,<!-- <ref name="Wassell 2008" />  --> asymmetry<!-- <ref name="Mujakperuo 2010" />  --> or deviation<!-- <ref name="Al-Ani 2004" />  --> of mandibular movement.<ref name="Mujakperuo 2010" /> 
# Noises from the joint during mandibular movement,<!-- <ref name="Mujakperuo 2010" />  --> which may be intermittent.<ref name="Al-Ani 2004" /> Joint noises may be described as clicking,<ref name="Mujakperuo 2010" /> popping,<ref name="Classification of Chronic Pain" /> or crepitus (grating).<ref name="Wassell 2008" />

TMJ dysfunction is commonly associated with symptoms affecting cervical spine dysfunction and altered head and cervical spine posture.<ref name=":11"/>

Other signs and symptoms have also been described, although these are less common and less significant than the cardinal signs and symptoms listed above. Examples include:
* Headache (possibly),<ref name="Al-Ani 2004" /> e.g. pain in the [[occiput|occipital region]] (the back of the head),<!-- <ref name="Neville 2001" /> --> or the forehead;<ref name="Neville 2001">{{cite book |vauthors=Neville BW, Damm DD, Allen CA, Bouquot JE |title=Oral & maxillofacial pathology |url=https://archive.org/details/oralmaxillofacia00nevi |url-access=limited |year=2002 |publisher=W.B. Saunders |location=Philadelphia |isbn=978-0-7216-9003-2 |pages=[https://archive.org/details/oralmaxillofacia00nevi/page/n87 75]–9 |edition=2nd}}</ref> or other types of facial pain including [[migraine]],<ref name="Okeson 2003" /> [[tension headache]],<ref name="Okeson 2003" /> or [[myofascial pain]].<ref name="Okeson 2003" />
* Pain elsewhere, such as the teeth<ref name="Neville 2001" /> or neck.<ref name="Edwab 2003" />
* [[Deafness|Diminished auditory acuity]] (hearing loss).<ref name="Okeson 2003" /> 
* [[Tinnitus]] (occasionally).<ref name="Wassell 2008" /> 
* Dizziness.<ref name="Edwab 2003">{{cite book |veditors=Edwab RR |title=Essential dental handbook : clinical and practice management advice from the experts |year=2003 |publisher=PennWell |location=Tulsa, OK |isbn=978-0-87814-624-6 |pages=251–309}}</ref> 
* Sensation of malocclusion (feeling that the teeth do not meet together properly).<ref name="Classification of Chronic Pain" />