Management and treatment of temporomandibular disorders: a clinical perspective

Abstract

A temporomandibular disorder (TMD) is a very common problem affecting up to 33% of individuals within their lifetime. TMD is often viewed as a repetitive motion disorder of the masticatory structures and has many similarities to musculoskeletal disorders of other parts of the body. Treatment often involves similar principles as other regions as well. However, patients with TMD and concurrent cervical pain exhibit a complex symptomatic behavior that is more challenging than isolated TMD symptoms. Although routinely managed by medical and dental practitioners, TMD may be more effectively cared for when physical therapists are involved in the treatment process. Hence, a listing of situations when practitioners should consider referring TMD patients to a physical therapist can be provided to the practitioners in each physical therapist's region. This paper should assist physical therapists with evaluating, treating, insurance billing, and obtaining referrals for TMD patients.

Keywords: Dentistry; Physical Therapy; Temporomandibular Disorders; Temporomandibular Joint.

FIGURE 1

Measuring the opening mandibular range of motion.

FIGURE 2

Palpating the anterior temporalis muscles.

FIGURE 3

Palpating the temporomandibular joints.

FIGURE 4

Locations responsible for producing referred pain to the different regions of the head.* *The superficial sites that have caused referred pain to the labeled regions of the head are highlighted on the drawing and the intraoral palpation locations are listed below the drawing.

FIGURE 5

An occlusal orthotic on a cast of the patient's teeth.