The Need for Multidisciplinary Treatment for TMD
An understanding of the interrelationship of the masticatory system, the temporomandibular joints, and the head and neck is imperative when evaluating and planning treatment for patients with temporomandibular dysfunction. Dentists, physicians, physical therapists, and medical professionals often have only a selective understanding of one area of the head and neck, limiting evaluation and treatment planning for patients with TMD. Consequently, a vast majority of patients with TMD may not be adequately evaluated for the cause of their dysfunction, appropriate treatment planning using a multidisciplinary approach fails to be implemented, and patients suffer unnecessary ongoing pain and further joint damage. Current research supports intervention for TMD dysfunction versus the often-held belief that little can be done for the patient with TMD:
The majority of patients do not improve without intervention and progress to further dysfunction. (1)
Acute close-locked patients should be unlocked immediately and stabilized with a splint by a dentist or physical therapist. (2)
Youth who suffer direct trauma to the jaw resulting in disc displacement often experience changes in growth of the mandible, facial asymmetry, clicking in the joint and early degenerative changes. (3), (4)
Adults who ignore years of clicking and popping can progress to acute close-lock conditions, degenerative joint disease and chronic pain. (5)
Faced with the complexity of this population, dental and medical care providers find that a coordinated team approach is the key to successful outcomes. This course provides evidence-based and clinically applicable skills to help you understand the role you can play on that multidisciplinary team.
1. Donald T. Brown, DDS, M.S.: Elmer L. Gaudet Jr. DDS Temporomandibular Disorder Treatment Outcomes: Second Report of a Large-Scale Prospective Clinical Study, MSD Journal of Craniomandibular Practice, October 2002, Vol.20, No. 4
2. Sembrano et al. Is there a role for arthrocentesis in recapturing the displaced disc in patients with closed lock of the temporomandibular joint?, Udine, Italy Department of Maxillofacial Surgery, Faculty of Medicine, University of Udine. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. Vol. 105 No. 3 March 2008
3. H. David Hall, DMD, MD. Intra-articular Disc Displacement Part II: Its Significant Role in Temporomandibular Joint Pathology. J Oral Maxillofac. Surg 53: 1073 – 1079, l995
4. Gidarakou et al. Comparison of Skeletal and Dental Morphology in Asymptomatic Volunteers and Symptomatic Patients with Bilateral Disc Displacement with Reduction.
Angle Orthodontist, Vol 72, No 6, 2002
5. Brook IR, Leeds LDS, Grander RM. Long-term prognosis for the clicking jaw. American Journal of Pain Management. 1988; 00065:668-678.