Chronic pain associated with temporomandibular disorders

Temporomandibular disorders (TMDs) are among the most common cause of chronic orofacial pain (pain lasting over three months).1 Chronic TMDs have a number of subtypes where the temporomandibular joint (TMJ), muscles of mastication, and adjacent structures may be variably affected. They are classed as a primary pain condition in the new chronic pain coding system of the International Classification of Disease, 11th revision.2 The demand for clinical guidance on TMDs management is clear: there have been five recent guidelines,34567 each with some identified limitations, plus nine previous network meta-analyses, which either investigated only a subset of interventions8910111213 or specific subtypes of TMDs.10131415 With more than 50 possible interventions identified, there is an urgent need for clear, comprehensive, evidence-based guidance to ensure that people with TMDs receive timely and effective management using the current best available evidence.

The new clinical practice guideline from Busse et al is a valuable addition to support management of chronic pain associated with TMDs.16 An international guideline development group with …