[Diagnosis and classification of temporomandibular dysfunction by the general dental practitioner]

Because of other diseases mimicking the symptoms of temporomandibular dysfunction (TMD), differential diagnosis is of the utmost importance. Diagnostic subgroups of TMD (osteoarthrosis, anterior disc displacement with/without reduction, TMD-myo) can be distinguished by a combination of active movements, passive opening and palpation. Active movement appeared to be the most powerful test for distinguishing the subgroups of TMD, e.g. myogenous, arthrogenous, myogenous and arthrogenous. It is advised to have an open mind in the clinical examination and to be aware of the many mimicking disorders before reaching a diagnosis. An anamnestic questionnaire addressing the pain history, signs and symptoms of TMD, functional impairments, correlates of TMD, psychosocial evaluation and general health status is mandatory. Headache and neck pain often accompany TMD. In appropriate situations it is advised to refer to the proper specialist, before starting treatment for TMD. Orthopedic tests of the cervical spine are of minor importance in discriminating between patients with TMD and patients with cervical spine disorders (CSD). It is therefore advised to evaluate the function of the stomatognathic system in patients with neck complaints to rule out a possible involvement of this system.