Why do TMD and Burning Mouth Syndrome Often Co-Exist?

“This overlap is largely due to shared underlying factors such as parafunctional habits—including bruxism (teeth grinding) and tongue thrusting/rubbing/moving—as well as psychosocial stressors that influence pain perception and muscle tension.”

Temporomandibular disorders (TMD) and burning mouth syndrome (BMS) are two seemingly distinct but often related conditions affecting the oral and maxillofacial region. They frequently can occur in the same patient. This overlap is largely due to shared underlying factors such as parafunctional habits—including bruxism (teeth grinding) and tongue thrusting/rubbing/moving—as well as psychosocial stressors that influence pain perception and muscle tension.

Bruxism and other oral parafunctions place excessive strain on the jaw muscles and temporomandibular joints, contributing to the development or exacerbation of TMD symptoms like jaw pain and muscle fatigue [1]. At the same time, repetitive tongue movements and stress-related oral habits can irritate the oral mucosa, which may trigger or worsen symptoms of burning mouth syndrome—a chronic pain condition characterized by a burning sensation in the tongue or other oral tissues without visible abnormalities [2].

Psychosocial factors such as anxiety, depression, and heightened pain sensitivity are well documented in both TMD and BMS patients, highlighting a biopsychosocial model where emotional and behavioral components influence the onset and severity of symptoms [3]. This shared pathway explains why many patients present with overlapping complaints of jaw discomfort and oral burning, making a multidisciplinary approach essential for accurate diagnosis and effective management.

At Oral Medicine of Wisconsin, we carefully evaluate these interconnected conditions, addressing both the physical and psychological contributors. By recognizing the commonalities between TMD and BMS, we can tailor treatment plans that include behavioral therapy, stress management, and conservative dental interventions to improve patient outcomes.

References

[1] Lobbezoo F, Ahlberg J, Glaros AG, et al. (2018). Bruxism Defined and Graded: An International Consensus. J Oral Rehabil, 45(1): 2–6.

[2] Grushka M. (2003). Burning Mouth Syndrome: Epidemiology, Pathogenesis, and Management. Dent Clin North Am, 47(4): 757–766.

[3] Zakrzewska JM. (2013). Neuropathic Orofacial Pain and Psychosocial Comorbidities. J Oral Rehabil, 40(3): 161–167.