Temporomandibular Disorders - Robin J. M. Gray

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      This chapter illustrates a classic history of a common TMD in a patient who thinks that she knows best. This highlights the importance of critical evaluation of the information (baggage) that a patient might bring to the consultation.

      This represents the most common condition about which you will be asked. Does a click need treatment? This raises your awareness of the need for treatment and the different treatment options for a commonplace complaint.

      Joint locking can be acute or long‐standing. Intervention is often necessary, but how and when? The various options are discussed, as is their practical relevance. We explore the range of options from ‘doing nothing’ to ‘surgery’.

      Degenerative joint disease in the temporomandibular joint is very different from disease in the hip. Nature has a part to play, but we can intervene to make life more tolerable for the person with the condition. Learn about the cyclical nature of this condition and its ramifications.

      Differential diagnosis is often a complex procedure but must not be avoided. You must avoid tunnel vision and keep an open mind about a patient's complaint no matter how badly explained or difficult to follow. Facial pain is a minefield of potential diagnoses and must be approached logically.

      Although true dislocation is rare, immediate action gives your patient (and you) the best chance of resolving the problem. Learn how to differentiate dislocation from other conditions and how to manage the acute case.

      Management of tooth surface loss is a complex treatment, but some straightforward rules will help in diagnosis of the cause, monitoring of the situation, and its management.

      Headache is a very complex condition even to diagnose. The relationship of headache to TMD is explored, as is the role of the dentist in treating patients whose primary complaint is headache.

      Nowadays litigation, especially in relation to road traffic accidents, is commonplace. TMD can be caused by a ‘whiplash‐type’ injury. Make sure that your examination of such a patient is comprehensive and that you are able to produce the necessary records on demand. Be aware that a TMD can become apparent immediately after an accident as well as becoming evident some time later.

      Litigation is never too far away! Although you should not practise ‘litigation dentistry’ because this is not in your patient's best interests, you should be aware of the common pitfalls. Above all else maintain good records and good communication, and do not over‐reach your abilities.

      A good referral letter is of great help to the specialist. A poor referral letter is a waste of everyone's time and can, on occasion, be embarrassing for all.

      This is a ‘how‐to‐do’ chapter. It is important for you to know what the technician does from impression taking to delivering the splint back to you ready for insertion and fitting. The patient will often ask about this and appreciate an explanation.

      This chapter deals with the most updated information about the postulated theories of aetiology and management of bruxism. New definitions and outcomes of recent international consensus are always discussed.

      The effectiveness of splint therapy for the management of TMD and Bruxism have been discussed in this chapter. The results of the most updated randomized controlled trials and systematic review have been discussed.

      This chapter contains 13 flowcharts which summarise some essential concepts in the management of a TMD. A reference for each relevant chart has been indicated in the text.

      This is more of a dictionary of terms than merely a glossary of terms used in this book. This provides the reader with a ‘TMD and occlusion’ dictionary.

      This chapter identifies the relevant terms from the glossary of prosthodontic terms published regularly in the Journal of Prosthetic Dentistry. Additional terms are added from the book A Clinical Guide to Temporomandibular Disorders, BDJ Publications, 1997.

      This chapter includes short answer questions for the reader to practise. The knowledge gained from reading this book will enable the reader to answer these questions effectively.

      There is a unique link to an online interactive multiple‐choice question (MCQ) site at www.wiley.com/go/al-ani/temporomandibular-disorders-2e. This quiz aims to test your knowledge of TMD and to make reading this book more enjoyable, stimulating, and productive.

      The joint anatomy, histology, structure, capsule, synovial membrane, and fluid, ligaments

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