All About Costen Syndrome in Dentistry
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The term “Costen Syndrome” is being increasingly replaced by the term “Myofacial Dysfunction”.

Costen Syndrome is also frequently known as temporo-mandibular joint disorder (TMJ).


It affects mostly younger people with their natural teeth. Patients with Costen Syndrome experience pain mainly in the area of the temple, base of the mouth, jaw angle, neck and in the side of the upper jaw. Pains often simultaneously radiate into the ear, towards the forehead, and/or toward the eye socket. In the auscultation of jaw joints, various occlusion noises are often found.

Cause (Etiology)

  • Frequently due to medical treatments (iatrogenic), e.g., in the course of dental treatments
  • Congenital malocclusions of the jaw (dysgnathia)
  • Trauma


Cause (Pathophysiology)

Parafunctions, including all activities in the masticatory organ that are exercised apart from the intrinsic function (chewing) such as, e.g.:

  • Idle grinding
  • Clenching (bruxism)
  • Cheek biting

The discomfort caused by the parafunctions are said to arise from an overstraining of the muscles used, which results in muscle pains. Nightly grinding of teeth (bruxism) in particularl involves forces that are far beyond those required for chewing.

Bruxism may be caused by dental dysfunctions such as misaligned teeth, but may also occur in absolutely correct alignments. Since treatment is rather different in both cases, it must first be determined whether there is a dysfunction in the tooth system. Stress, depression, and psycho-emotional factors are also considered to be triggers.


Therapy should be chosen on the basis of the cause triggering the discomfort. In many cases, informing and reassuring the patient is sufficient.

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