Intraoral orthotic therapy

Despite the unanswered questions on the physiologic mechanisms that explain the effectiveness of intraoral orthotics on reducing symptoms of TMD, there is still a plethora of documentation that intraoral orthotics, when appropriately used in the management plan, can contribute to the relief of TMD symptoms. The clinician is encouraged to evaluate fully each particular patient case in an effort to develop a differential diagnosis that leads to an effective management plan, which, in turn, addresses the cause(s) as best as possible. Before commencing any intraoral orthotic therapy for a TMD, the clinician should be confident that the patient will benefit from the therapeutic approach to be employed or, at least, that the resultant effect, or lack thereof, on the symptoms will provide additional diagnostic information. The clinician also needs to take into account that approximately 40% of patients suffering from TMD demonstrate a favorable response to intraoral orthotic therapy just from a placebo effect. As with any treatment, a good patient-dentist relationship concomitant with patient education can allay patient concerns and anxieties, which, in and of themselves, can contribute to a positive and favorable response to intraoral orthotic therapy.