Food Avoidance, Masticatory Limitation, and Mediterranean Diet Adherence in Degenerative and Non-Degenerative Temporomandibular Disorders: A Cross-Sectional Study

Background/Objectives: It is unclear whether patients with degenerative temporomandibular disorders (TMD) eat a poorer diet or simply eat differently. We examined whether diet quality and jaw functional limitation were associated with the severity of cone-beam computed tomography (CBCT)-assessed condylar degeneration. Methods: One hundred adults with TMD (60 with and 40 without CBCT-confirmed degeneration) completed the MEDAS-14, the JFLS-20, a food-frequency questionnaire and an investigator-developed questionnaire on avoidance, texture and weight change. Results: MEDAS-14 scores neither differed between groups (5.62 ± 1.43 vs. 6.15 ± 1.70; p = 0.087) nor correlated with erosion severity (ρ = −0.09), whereas JFLS-20 scores were higher in the degenerative group and correlated with erosion severity overall (ρ = 0.42; both p < 0.001), but not within the degenerative group. Degenerative patients avoided more items, also after adjusting for pain diagnoses, and less often preferred foods of any consistency; chewing-gum avoidance was more frequent (30.0% vs. 5.0%; p = 0.002), and weight loss was self-reported by 28.3% vs. 2.5% (p < 0.001). Conclusions: Degenerative TMD was associated with food avoidance and masticatory limitation, whereas Mediterranean diet adherence did not differ significantly; nutrient intake was not measured. Dietary assessment may need to address how food is eaten, not only what.