Diagnosis and management of temporomandibular disorders: a personal clinical experience

This article presents the reflections of a clinician who has been involved in the diagnoses and management of temporomandibular disorders (TMDs) for approximately 40 years. It provides an illustration of how our understanding of TMDs has advanced over the years. The author describes how an adverse reaction to a routine restorative procedure led to a study of the articulatory system.This opinion paper discusses several key points regarding TMD diagnosis and management, distilled through decades of practical experience. TMD is a phrase that encompasses distinct diagnoses; it is not a single condition, and not all TMDs affect the temporomandibular joint (TMJ). The development of sound classification systems for TMD have been an aid to both research into and clinical management of TMD. TMDs are multifactorial and effective management will require a multidisciplinary approach. In the case of a chronic pain TMD patient an understanding of the effects that chronic pain can have on the general wellbeing of the patient is invaluable, and dentists are encouraged to acknowledge and develop such skills. There is an important role for the general dental practitioner in the diagnosis and management of TMD.