479: Lip Strength in Painful Temporomandibular Disorders: A Cross-Sectional Study

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary orofacial pain, Assessment and Measurement of Pain/Nociception, Electrophysiology/Clinical neurophysiology (e.g. microneurography, EEG, MEG, OPMs, TMS) , Treatment/management

Background and Aims: Temporomandibular disorders (TMD) may affect the stomatognathic system and alter tongue performance. In the ICD-11, TMD is classified as chronic primary orofacial pain and may be associated with functional impairment of trigeminally innervated muscles, including the tongue. This study aimed to evaluate tongue strength parameters and their relationship to swallowing function in individuals diagnosed with TMD.

Methods: A cross-sectional study was conducted including 50 adults (32 with TMD and 18 asymptomatic controls). TMD diagnosis followed the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Swallowing function was assessed using the Eating Assessment Tool (EAT-10), and tongue strength was measured using the Pro-Fono Lip and Tongue Pressure (PLTP) biofeedback device. The sample included 50 participants (mean age: 37.7 years), 12 men (mean age: 35.3 years) and 38 women (mean age: 41.1 years). Among individuals with TMD, 11 presented myalgia, 8 arthralgia, and 13 both diagnoses simultaneously.

Results: According to the EAT-10, 40 participants scored below 3, while 10 scored ≥3, suggesting a potential risk of swallowing alterations. Participants with TMD exhibited significantly lower tongue strength at the dorsum and tip of the tongue compared with controls (p < 0.05). No significant differences in tongue strength were observed by sex or age group, and no association was found between tongue pressure and EAT-10 scores. Although perceived swallowing difficulty did not differ between groups, reduced tongue performance was evident in the TMD group.

Conclusions: Individuals with TMD exhibited reduced tongue strength compared with asymptomatic controls, despite no clear association with self-reported swallowing symptoms. These findings support the use of tongue strength assessment as a relevant functional measure to incorporate into the clinical evaluation and management of patients with chronic orofacial pain related to TMD.

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Presenting Author: Jose Stechman-Neto
Submitting Author: José Stechman-Neto

Senior Author: Jose Stechman-Neto

IASP 2026 Global Year theme of Neuropathic Pain: No

• Julia da Silva Germiniani: DDS, MSc in Human Communication Health, PhD Student - Tuiuti University of Parana - Orofacial Pain and TMD Center (CDATM)
• Milena Sampaio Kuckera: DDS, Master’s student in Dentistry - Tuiuti University of Parana - Orofacial Pain and TMD Center (CDATM)
• Rodolfo Jorge Fortes Kubiak: DDS, Master’s student in Dentistry - Tuiuti University of Parana - Orofacial Pain and TMD Center (CDATM)
• Glória Ravazzi: DDS, PhD - Orofacial Pain and TMD Center (CDATM)
• Rosane Sampaio Santos: PhD, Post Doctoral - Tuiuti University of Parana
• Bianca Simone Zeigelboim: PhD, Post Doctoral - Tuiuti University of Parana
• Reynaldo Todescan Jr.: DDS, MSc, PhD, Dipl Pros - Dr Gerald Niznick College of Dentistry | Rady Faculty of Health Sciences University of Manitoba
• Angela Graciela Deliga Schroder: PhD, Post Doctoral - Tuiuti University of Parana - Faculty of Dentistry
• Flavio Magno Gonçalves: DDS, PhD - Tuiuti University of Parana - Faculty of Dentistry - Orofacial Pain and TMD Center (CDATM)
• José Stechman-Neto: DDS PhD Pst Doctoral - Tuiuti University of Parana - Faculty of Dentistry - Orofacial Pain and TMD Center (CDATM)