Syndrome SADAM (syndrome algo-dysfonctionnel de l’articulation temporo-mandibulaire)

Abstract

Excessive stress on either temporo-mandibular capsules or pterygoid muscles can lead to temporo-mandibular dysfunction (TMD) in roughly 5% of people. The TMD syndrome is a mix of regional hypersensitivity and myo-fascial pain arising from neighbouring muscles (masseter, temporalis, sternocleidomastoid, scalenus, trapezus). Main symptoms are cervicalgia and temporal and occipital headaches. Tinnitus and otalgia can also be found and are suggestive of the diagnosis when they occur during mouth opening. Pain in the throat and the face can also be noticed. Several underlying disorders must be searched for: malocclusion, sometimes induced by orthodontics treatments; inappropriate dental prosthesis; abnormal deglutition with tongue interposition during the 2500 oral stages of swallowing, so that speech therapist advice can be welcome. A tenderness of the temporo-mandibular joint, an audible “click”, and an asymmetrical opening of the mouth, reduced to less than three fingers, must be also be searched too. Cognitive-behavorial treatment and intra oral hard stabilization appliances seem the most effective treatments of this frustrating disorder.