The prevalence and symptoms of temporomandibular disorders in head and neck cancer patients

Acta Odontol Scand. 2022 May;80(4):252-257. doi: 10.1080/00016357.2021.1991470. Epub 2021 Oct 15.


Objectives: This retrospective patient survey aimed to assess the prevalence of temporomandibular disorders (TMD) before and after curative oncological treatment and to identify possible risk factors.

Materials and methods: Patients with squamous cell carcinoma in the tonsil or base of the tongue were included (n = 217). Medical records were collected to assess TMD prevalence before oncological treatment and at 6- and 12-month follow-up. Fisher's test and Pitman's test were used.

Results: Significantly reduced mouth opening was observed after oncological treatment at 6- and 12-month follow-up (p < .001). Symptoms from the temporomandibular joint and jaw muscles plus pain upon palpation (p = .0083, p < .001, respectively) and self-reported pain upon chewing (<0.001) and opening the mouth (<0.001) increased 12 months following radiotherapy. Pain and degree of mouth opening prior to treatment, self-reported depression, overall health status, brachytherapy and jaw exercise during radiotherapy were factors affecting the increase of TMD symptoms.

Conclusion: All TMD symptoms escalated significantly one year after radiotherapy except self-reported sounds from the temporomandibular joint. Reduction in the degree of mouth opening and pain in the jaw muscles and the temporomandibular joint when opening the mouth and upon chewing were commonly reported symptoms following radiotherapy. Several potential risk factors were identified.

Keywords: Temporomandibular disorders (TMD); head and neck neoplasms; radiotherapy; symptoms.

MeSH terms

  • Facial Pain / epidemiology
  • Head and Neck Neoplasms* / complications
  • Head and Neck Neoplasms* / radiotherapy
  • Humans
  • Pain / complications
  • Prevalence
  • Retrospective Studies
  • Temporomandibular Joint Disorders* / diagnosis
  • Temporomandibular Joint Disorders* / epidemiology
  • Temporomandibular Joint Disorders* / etiology