Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.20260009
Revista de Odontologia da UNESP
Original Article

Prevalence of TMD in Parkinson’s disease: an observational study

Prevalência de DTM na doença de Parkinson: um estudo observacional

Nicole Anália Borges ROCHA; Eduvaldo Campos SOARES JÚNIOR; Luís Henrique Araújo RAPOSO; Paulo Cézar SIMAMOTO JÚNIOR

Downloads: 0
Views: 13

Abstract

Introdução: A Doença de Parkinson (DP) apresenta características neurodegenerativas e progressivas, sendo tipicamente associada à perda de neurônios dopaminérgicos na região compacta da substância negra do mesencéfalo. Sintomas motores, como rigidez, bradicinesia e tremor de repouso, podem afetar a musculatura orofacial, resultando em sinais e sintomas semelhantes aos observados nas disfunções temporomandibulares (DTM). Consequentemente, comorbidades musculares, como a DTM, podem ser mascaradas, levando ao subdiagnóstico e até mesmo à ausência de tratamento.

Objetivo: Avaliar a prevalência de DTM em indivíduos com DP e investigar sua associação com os estágios da doença.

Material e método: A amostra foi composta por 31 pacientes, com idades entre 40 e 75 anos, diagnosticados com DP nos estágios 1, 2 e 3, de acordo com a escala de Hoehn & Yahr (H&Y). Os participantes foram recrutados no Ambulatório de Neurologia do Hospital de Clínicas da Universidade Federal de Uberlândia e avaliados por meio dos critérios diagnósticos para Disfunções Temporomandibulares (DC/TMD) e do Mini Exame do Estado Mental (MEEM). Todos os participantes foram avaliados sob condição medicamentosa habitual.

Resultado: A amostra revelou discreto predomínio do sexo masculino entre os pacientes com DP. Embora não tenha sido encontrada associação estatisticamente significativa entre DP e DTM, observou-se maior frequência de casos de DTM no estágio 2 da doença, sendo as alterações articulares as mais prevalentes.

Conclusão: Pacientes com DP não apresentaram associação significativa entre os estágios da doença e a DTM; entretanto, a presença de DTM, especialmente de origem articular, reforça a importância da avaliação clínica para evitar o subdiagnóstico nessa população.

Keywords

Temporomandibular joint disorders; Parkinson disease; facial pain

Resumo

Introduction: Parkinson's Disease (PD) has neurodegenerative and progressive characteristics and is typically associated with the loss of dopaminergic neurons in the compact region of the substantia nigra of the midbrain. Motor symptoms such as rigidity, bradykinesia, and resting tremor can affect the orofacial muscles, resulting in signs and symptoms similar to those of Temporomandibular Disorders (TMD). As a result, muscular comorbidities like TMD may be masked, leading to underdiagnosis and even lack of treatment.

Objective: To evaluate the prevalence of TMD in individuals with PD and to investigate association with disease stages.

Material and method: The sample consisted of 31 patients, aged between 40 and 75 years, with PD stages 1, 2, and 3, according to the Hoehn & Yahr (H&Y) scale. The individuals were recruited from the Neurology Clinic at the Clinical Hospital of the Federal University of Uberlândia and analyzed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and questionnaire and the Mini-Mental State Examination (MMSE). All participants were evaluated under their usual medicated condition.

Result: The sample revealed a slight male predominance among PD patients. Although no significant association was found between PD and TMD,a higher frequency of TMD cases was observed in patients at stage 2 of PD. Joint disorders were the most prevalent subtype.

Conclusion: Patients with PD did not show a significant association between disease stages and TMD; however, TMD, especially joint disorders, was observed, highlighting the importance of clinical evaluation to avoid underdiagnosis in this population.

Palavras-chave

Disfunções da articulação temporomandibular; doença de Parkinson; dor facial

References

1 Yao SC, Hart AD, Terzella MJ. An evidence-based osteopathic approach to Parkinson disease. Osteopathic Family Physician. 2013 May-June;5(3):96-101. https://doi.org/10.1016/j.osfp.2013.01.003.

2 Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson’s disease. Lancet Neurol. 2021 May;20(5):385-97. https://doi.org/10.1016/S1474-4422(21)00030-2. PMid:33894193.

3 Goulart F, Pereira LX. Uso de escalas para avaliação da Doença de Parkinson em fisioterapia. Fisioter Pesqui. 2005;11(1):49-56. http://doi.org/10.1590/S1809-29502005000100009.

4 Gottlieb M, Long B. Managing temporomandibular joint dislocations. Ann Emerg Med. 2022 Dec;80(6):539-47. https://doi.org/10.1016/j.annemergmed.2022.05.031. PMid:35842342.

5 de Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. 6th ed. Chicago: Quintessence; 2018.

6 Silva TVA. Força de mordida e atividade elétrica dos músculos mastigatórios em pessoas com doença de Parkinson [dissertação]. Recife: Universidade Federal de Pernambuco; 2018 [cited 2026 Mar 10]. Available from: https://repositorio.ufpe.br/handle/123456789/30987

7 Borsook D. Neurological diseases and pain. Brain. 2012 Feb;135(Pt 2):320-44. https://doi.org/10.1093/brain/awr271. PMid:22067541.

8 Silva TVA, Coriolano MGWS, Lins CCSA. Disfunção temporomandibular na Doença de Parkinson: uma revisão integrativa da literatura. Rev CEFAC. 2017 Set-Out;19(5):702-11. https://doi.org/10.1590/1982-0216201719516416.

9 Baram S, Thomsen CE, Øzhayat EB, Karlsborg M, Bakke M. Orofacial function and temporomandibular disorders in Parkinson’s disease: a case-controlled study. BMC Oral Health. 2023 Jun;23(1):381. https://doi.org/10.1186/s12903-023-03051-6. PMid:37308874.

10 Silva PFC, Motta LJ, Silva SM, Ferrari RAM, Fernandes KPS, Bussadori SK. Computerized analysis of the distribution of occlusal contacts in individuals with Parkinson’s disease and temporomandibular disorder. Cranio. 2016 Nov;34(6):358-62. https://doi.org/10.1080/08869634.2015.1097315. PMid:26714395.

11 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189-98. https://doi.org/10.1016/0022-3956(75)90026-6. PMid:1202204.

12 Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6-27. https://doi.org/10.11607/jop.1151. PMid:24482784.

13 Field A. Descobrindo a estatística usando o SPSS. 2. ed. Porto Alegre: Artmed; 2009. Capítulo 14, Análise de Variância Multivariada (MANOVA); p. 515 [cited 2026 Mar 10]. Available from: https://books.google.com.br/books?id=Hl3dDwAAQBAJ

14 Cabreira V, Massano J. Doença de Parkinson: revisão clínica e atualização. Acta Med Port. 2019 Oct;32(10):661-70. https://doi.org/10.20344/amp.11978. PMid:31625879.

15 Silva PF, Biasotto-Gonzalez DA, Motta LJ, Silva SM, Ferrari RA, Fernandes KP, et al. Impact in oral health and the prevalence of temporomandibular disorder in individuals with Parkinson’s disease. J Phys Ther Sci. 2015 Mar;27(3):887-91. https://doi.org/10.1589/jpts.27.887. PMid:25931752.

16 O’Neill F, Kobylecki C, Carrasco R, Hu MT, Grosset D, Silverdale M. Orofacial pain in 1916 patients with early or moderate Parkinson disease. Pain Rep. 2021 Apr;6(1):e923. https://doi.org/10.1097/PR9.0000000000000923. PMid:33981938.

17 Verhoeff MC, Koutris M, Tambach S, Eikenboom D, de Vries R, Berendse HW, et al. Orofacial pain and dysfunction in patients with Parkinson’s disease: a scoping review. Eur J Pain. 2022 Nov;26(10):2036-59. https://doi.org/10.1002/ejp.2031. PMid:36063442.

18 Minervini G, Franco R, Marrapodi MM, Ronsivalle V, Shapira I, Cicciù M. Prevalence of temporomandibular disorders in subjects affected by Parkinson disease: a systematic review and metanalysis. J Oral Rehabil. 2023 Sep;50(9):877-85. https://doi.org/10.1111/joor.13496. PMid:37183340.

19 Smulders K, Dale ML, Carlson-Kuhta P, Nutt JG, Horak FB. Pharmacological treatment in Parkinson’s disease: effects on gait. Parkinsonism Relat Disord. 2016 Oct;31:3-13. https://doi.org/10.1016/j.parkreldis.2016.07.006. PMid:27461783.

20 Tai YC, Lin CH. An overview of pain in Parkinson’s disease. Clin Park Relat Disord. 2019 Nov;2:1-8. https://doi.org/10.1016/j.prdoa.2019.11.004. PMid:34316612.

21 Chen YY, Fan HC, Tung MC, Chang YK. The association between Parkinson’s disease and temporomandibular disorder. PLoS One. 2019 Jun;14(6):e0217763. https://doi.org/10.1371/journal.pone.0217763. PMid:31199837.
 


Submitted date:
03/10/2026

Accepted date:
04/14/2026

6a4baf6fa953952b1d4d1d64 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections