Parameters of odontostomatognathic disability: guidelines for evaluation of impaired simple and complex human...

This paper explores the current status and the future of efforts to establish parameters of disability for the odontostomatognathic functional system ("the teeth, mouth, jaws and related structures as they subserve the functions of mastication, deglutition, digestion, speech, facial expression, respiration, sexual activity, appearance and posture"). Illness, disorders, disease or injuries involving this functional system include a broad spectrum of problems that affect the dental and paradental structures. The dentist is the primary healthcare provider (HP) in the diagnosis, treatment and impairment/disability/handicap status (IDH) decisions. The authors point out that the first stage of establishing parameters of odontostomatognathic disability was accomplished with recognition in the AMA Guides to Evaluation of Permanent Impairment of the temporomandibular joint and the masticatory musculature. The second stage will be the AMA Guides publishing of an objective rating system for functional impairment of the temporomandibular joint and the masticatory musculature. Prior to the third stage of actually establishing parameters of odontostomatognathic disability, the authors suggest that multiple objectives must be accomplished, including: 1. a change in current healthcare terminology; 2. an agreement on the organization of human physiological systems; 3. medical community acceptance of the integrated structures and functions of the odontostomatognathic functional system; and 4. an appreciation of both Level I (joint and muscle dysfunction) and Level II (complex odontostomatognathic dysfunction including problems with mastication, deglutition, digestion, speech, facial expression, respiration, sexual activity, appearance and posture). The authors conclude that once these objectives are met, parameters of odontostomatognathic disability can be established.