Introduction

Temporomandibular disorders (TMD) are a group of musculoskeletal disorders of the masticatory system. These disorders are common and dentists are the primary care providers. Therefore every dentist should have a sound understanding of these disorders so that the most appropriate care will be selected for the patient. Often simple care can make big differences in the patient’s quality of life.

In the past, dentists have attempted to manage their TMD patients by utilising standard dental approaches which have not always proven to be successful. In fact our profession has many concepts and theories that attempt to solve musculoskeletal problems with dental therapies, many of which have little to no scientific support. This presentation will describe the present evidence that either supports or disproves these concepts, including how occlusion may or may not affect TMD. Other areas that will be discussed are etiologic considerations and treatment strategies, including the use of occlusal appliances. This presentation will attempt to separate the facts from the fantasies in the area of TMD. 

WHAT YOU WILL LEARN

• To identify those pain disorders that will likely respond to your therapy from those that will not.
• That listening to how the patient describes the pain will help diagnose the pain condition.
• The relationship between occlusion, bruxism and temporomandibular disorders.
• The most favourable orthopedically stable relationship between the occlusion and condylar position for  restorative dentistry.
• When occlusal changes are indicated for the management of TMD.
• When it is appropriate to consider orthodontic or surgical therapy for a TMD patient.
• Which headaches are best managed in the dental office and how to successfully treat them.
• The appropriate use of occlusal appliance therapy for muscle pain and joint pain.
• When an occlusal appliance reduces the patient’s TMD symptoms, what to do next.

A Participation Program on the Clinical Management of Temporomandibular Disorders

INTRODUCTION

This participation course will allow the clinician to bring questions regarding issues related to TMD to Dr. Okeson in a small group setting. Each participant will be able to select a TMD patient from his or her practice and record the history and examination on a standard form. The participant will bring this information to the group and Dr. Okeson will lead a discussion on establishing the diagnosis and developing a treatment plan. Dr. Okeson will also be open to discuss any aspect of TMD and orofacial pain these participants wish to deliberate.

WHAT YOU WILL LEARN

• Learn the important aspects of taking a pain history.
• Learn the components of a TMD examination and how they are used in establishing the diagnosis.
• Learn the keys to developing a TMD treatment plan.
• Learn how and when to use a stabilisation appliance and an anterior positioning appliance.
• Learn techniques for diagnostic anaesthetic injection.

IN ADDITION, THE GROUP MAY SELECT OTHER TOPICS TO BE DISCUSSED FROM THIS LIST:

• The use of Botox in dentistry.
• Seven different toothaches of non dental origin: Differential Diagnosis and management considerations.
• Understanding migraine.
• Diagnosis, etiology and management of trigeminal neuralgia.
• Diagnosis, etiology and management of continuous neuropathic pain disorders.