Management of Temporo-mandibular Disorders (TMDs)

We receive a large number of referrals for the assessment of temporo-mandibular disorders (TMDs). There is good, recent evidence that a large proportion of these patients can be managed in the primary care dental & medical setting.

TMDs are musculo-skeletal disorders and represent the most common cause of chronic pain in the orofacial region.

There are three main groups of TM problems.

1) Temporo-mandibular myofascial pain dysfunction (TMD / MFPDS). This is essentially an acute or chronic soft tissue pain problem.

2) Temporo-mandibular joint articular surface arthritis. Essentially osteo or less commonly rheumatoid arthritis of the condylar head of the mandible or glenoid fossa / articular eminence system.

3) Internal derangement of the cartilage disc and associated muscular groups.

In addition there may be instances when more than one of the above is present in the same patient.

We do appreciate that the assessment, diagnosis and management of patients with these conditions is notoriously challenging. The following guidance has, for the first time, provided comprehensive information, with input from many different speciality groups from restorative dentistry, pain managament and oral / maxillofacial surgery to name but a few.

This document contains an overview of the current treatment options available to patients who have temporo-mandibular disorders (TMDs). The authors are the UK Specialist Interest Group in Oro-facial Pain and TMDs. It is published by the Faculty of Dental Surgery, Royal College of Surgeons (Eng).

Guidelines for the management of TMDs by Primary Care Medical & Dental Practitioners

Gloucestershire Hospitals OMFS Dept. Patient Information Leaflet for TMD problems

Page updated 21/01/16