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Multidisciplinary care of patients with TMD

Where Function Meets Teeth - amid the prevalent belief that temporomandibular joint dysfunction (TMD) is either non existent, self limiting or a presentation of psychological dysfunction, the practice of cranio-mandibular orthopaedics and rehabilitation can be a lonely place to work.

However, there is a growing group of mixed professional disciplines who share a common understanding that TMD is real and prevalent in the population and that ignoring the signs and symptoms is just not an option in the care of our patients.

There is a clear need to foster collaboration between colleagues from dentists to osteopaths, chiropractors, specialists in pain control, pysiotherapists, oral and maxillofacial surgeons, ENT specialists and numerous others  in the interests of achieving treatment goals for our patients. TMD has many presentations and no single, defined  treatment pathway will suit every individual case. We should celebrate the multiplicity of options for treatment.

Common to every approach however is a need for clear diagnosis with reproducible measurement to evaluate and audit our treatments. We must set objectives and goals for treatment, know when to start treatment and when to stop. When we work collaboratively we need to use common language and terms to allow for continuity and transparency of care.

Granta Dental is now ready to use our newly extended facilities as a centre for a local or regional study group under the auspices of the British Society for the Study of Craniomandibular Disorders, with the aim of encouraging collaboration and sharing of knowledge in an informal but clinical setting. We are keen to share our diagnostic approach in particular with the use of biometric equipment for the measurement and recording of temporomandibular joint, muscle and occlusal function. Integration of  Joint Vibration Analysis, Jaw Tracking, Electromyography and T-Scan into the diagnosis and treatment management process is a cost effective way to keep meticulous records. These functional records add an extra dimension to the information acquired by clinical observation, x-rays and MRI scans that allows inexpensive tracking of treatment progress and monitoring. Trained ancillary staff are able to take the records and produce the reports which ensure that clear reproducible treatment records are maintained and patients have a much greater understanding of their condition. Use of biometrics is an excellent way to improve clinical observation, providing verification of findings and an invaluable way to learn and develop.

Future development and acceptance of effective treatments for temporomandibular dysfunction requires diagnostic tools and development of skills that are the foundation for collection of meaningful data from which treatment options and outcomes can be shared, learned and developed. 

The art of cranio-mandibular therapy needs to be adapted to a science to support, improve and extend the clinical practice.  

The Midlands and East Anglia Region study group of the British Society for the Study of Cranio-Mandibular Dysfunction will be holding its innaugural meeting on Friday 19th April 2013. Any clinician involved and interested in the field of temporomandibular joint dysfunction (TMD) will be very welcome to join us. Come along and share your experiences.

Posted on 4 March 2013
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