Temporomandibular Disorders

Preface to the Second Edition ix Acknowledgements xi About the Companion Website xiii 1 About the Book 1 About temporomandibular disorders: what is a ‘TMD’? 1 About the book 2 Chapter 2: Clinical aspects of anatomy, function, pathology, and classification 3 Chapter 3: Articulatory system examination 3 Chapter 4: I’ve got ‘TMJ’ 3 Chapter 5: I’ve got a clicking joint 3 Chapter 6: I’ve got a locking joint 3 Chapter 7: I’ve got a grating joint 3 Chapter 8: You’ve changed my bite 4 Chapter 9: I’ve got pain in my face 4 Chapter 10: I’ve got a dislocated jaw 4 Chapter 11: My teeth are worn 4 Chapter 12: I’ve got a headache 4 Chapter 13: I’ve got whiplash 4 Chapter 14: What’s of use to me in practice? 5 Chapter 15: You and the lawyer 5 Chapter 16: The referral letter 5 Chapter 17: How to make a splint 5 Chapter 18: Bruxism: Current knowledge of aetiology and management 5 Chapter 19: Splint therapy for the management of TMD patients: An evidence-based approach 5 Chapter 20: Patient information 6 Appendix I: Flowcharts 6 Appendix II: Glossary of terms 6 Appendix III: Short answer questions 6 2 Clinical Aspects of Anatomy, Function, Pathology, and Classification 7 The joint anatomy, histology, structure, capsule, synovial membrane, and fluid, ligaments 7 The intra-articular disc (meniscus) 11 The bones of the temporomandibular joint 15 Mandibular (jaw/masticatory) muscles 16 Classification and Pathology 25 Diagnoses of TMDs 29 Further Reading 31 3 Articulatory System Examination 32 Examination of the temporomandibular joints 32 Mandibular (masticatory) muscle tenderness 39 Further Reading 50 4 I’ve Got ‘TMJ’! 52 History 52 Examination 53 Special tests 55 Differential diagnosis 55 Management 56 5 I’ve Got a Clicking Joint 64 History 64 Examination 65 Other special tests 67 Treatment 74 The patient journey 79 6 I’ve Got a Locking Joint 82 History 82 Examination 1 83 Diagnosis 85 Treatment 86 TMJ locking 88 Conclusion 90 7 I’ve Got a Grating Joint 91 Examination 91 Diagnosis 92 Treatment 92 Final treatment plan 95 8 You’ve Changed My Bite 101 History 101 Examination 104 Treatment 104 Discussion 106 Conclusion 111 Further Reading 112 9 I’ve Got Pain in My Face 114 History 114 Examination 115 Differential diagnosis 116 Treatment 121 Questions to ask patients regarding pain in general 122 Further Reading 123 10 I’ve Got a Dislocated Jaw 125 Examination 126 Likely diagnoses 126 Management 127 11 My Teeth Are Worn 132 History 132 Examination 133 Diagnosis 135 Treatment 135 Important considerations in tooth surface loss 136 Further reading 147 12 I’ve Got a Headache 148 Examination 149 Radiographs 149 Articulatory system exam 150 Likely diagnosis 151 Management 153 Patient journey 154 Further Reading 155 13 I’ve Got Whiplash 156 Examination 157 Record-keeping 158 Are TMD and whiplash related? 159 Likely diagnosis 161 Management 161 14 What’s of Use to Me in Practice? 164 Counselling and reassurance 165 Drug therapy 165 Physiotherapy 166 Splint therapy 168 Mouth prop 171 Occlusal adjustments 171 Does orthodontic treatment cause TMD? 175 Restorative treatment, the dentist, and TMD 176 The use of a facebow and semi-adjustable articulators 177 Radiographs 178 Further referral 178 15 You and the Lawyer 182 Case scenario 1: note and record-keeping 182 Case scenario 2: a medical report request 185 Case scenario 3: a disgruntled patient 188 Further Reading 191 16 The Referral Letter 192 Details 192 History 192 Request 194 Further Reading 194 17 How to Make a Splint 195 How do you make a stabilisation splint? 195 Fitting a stabilisation splint 205 How do you make an anterior repositioning splint? 211 Bite registration 213 Further reading 217 18 Bruxism: Current Knowledge of Aetiology and Management 218 Aetiology of bruxism 218 Definition of bruxism 219 Bruxism and TMD 220 Why bruxism (parafunction) is potentially damaging? 221 How much evidence about the efficacy of botulinum toxins on bruxism? 221 How can bruxism be managed? 222 Further reading 223 19 Splint Therapy for the Management of TMD Patients: An Evidence-Based Discussion 224 Stabilisation splint (SS) 225 Anterior repositioning splint (ARPS) 228 Mandibular advancement/snoring appliances 231 20 Patient Information 235 Stabilisation splint 235 Anterior repositioning splint 236 Use and care of occlusal bite splint 236 General advice for patients with a TMD 238 Exercise programme for patients with TMD 239 Appendix I Flowcharts 241 Appendix II Glossary of Terms 253 Further Reading 274 Appendix III Short Answer Questions 275 Index 277