TMD Current Concepts: 1. An Update

From Volume 34, Issue 5, June 2007 | Pages 278-288

Authors

Ziad Al-Ani

BDS, MSc, PhD, MFDS RCS(Ed), FHEA, BDS, MSc, PhD, MFDS RCS(Ed), PG Cert Ac Pract, RET

Clinical Teacher in Restorative Dentistry, The University of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK

Articles by Ziad Al-Ani

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Robin Gray

BDS, MDS, PhD, MFGDP

Formerly Senior Lecturer in Dental Medicine and Surgery, School of Dentistry, The University of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK

Articles by Robin Gray

Abstract

This, the first of two articles, addresses current concepts of aetiology, diagnosis and management of temporomandibular disorders (TMD). The aim is to direct the reader toward a more evidence-based approach; specific treatment regimes can be accessed elsewhere. The concept of these articles is to encourage the reader to think about the wider ramifications of TMD, with specific relevance to their management in general dental practice. This article addresses current controversial concepts, including occlusion, tinnitus, hearing, speech defects and bruxism. The second part addresses the need for imaging and explores treatment concepts. TMD management in general dental practice is widely regarded as being a contentious subject, with several differing and often diametrically opposed viewpoints being aired, not only in relation to aetiology and diagnosis but also in relation to treatment. This uncertainty often prompts the dentist to refer for secondary care. Another recurring issue is the lack of adequate remuneration in the general dental services for management of the patients, for example by splint therapy.

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