Chapter 34 - Masticatory System Disorders That Influence the Periodontium

Abstract

The masticatory system is often described by complex interactions of neurologic inputs, muscular function and dysfunction, osseous structures, ligaments, tendons, and all the oral structures. Though the periodontium is only a component of these extensive anatomical features of this system, it is subjected to both physiologic and excessive forces, and it is the source of most of the critical neurologic input to the musculature from the occlusal contacts. Patients presenting for any dental care may be experiencing any of a variety of disharmonies with a wide range of symptoms, with or without accommodations. Comprehensive care requires complete evaluation of all aspects of the masticatory system on an initial and an ongoing basis. Change from functional harmony within the system can occur from acute or chronic stress with resulting continued disharmony, which may or may not be associated with limited function and/or pain. Extended dental procedures, including those directed at periodontal health, can further stress the muscular components and compromise functional range of motion of either or both temporomandibular joints, with or without discomfort. A differential diagnosis with other sources of orofacial pain may need to be pursued if the patient’s history does not indicate a source of discomfort directly connected to muscles of mastication or dislocation of either condyle. Consensus has not been acquired within the dental profession regarding the most appropriate and effective intervention for masticatory system disharmonies.