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References

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Temporomandibular disorders. Part 2: non-surgical management

From Volume 49, Issue 5, May 2022 | Pages 380-386

Authors

Emma Foster-Thomas

Academic Clinical Fellow in Restorative Dentistry, University Dental Hospital of Manchester

Articles by Emma Foster-Thomas

Martin James

Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester

Articles by Martin James

Charles Crawford

Lead Clinician TMD Clinic, University Dental Hospital of Manchester

Articles by Charles Crawford

Pete Clarke

BDS(Hons), MFDS, MPerio

Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester

Articles by Pete Clarke

Funmi Oluwajana

Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester; Clinical Fellow, Health Education England Northwest

Articles by Funmi Oluwajana

Email Funmi Oluwajana

Cathleen Lancelott-Redfern

BSc(Hons), HCPC, MCSP

TMD and Chronic Pain Specialist Physiotherapist, Royal Manchester Children's Hospital

Articles by Cathleen Lancelott-Redfern

Abstract

For optimal success, a multidisciplinary team approach that uses a combination of non-surgical treatment modalities is recommended in the care of TMD patients. In this article, the second in a series of six focusing on the diagnosis and management of temporomandibular disorders (TMD), the importance of self-management, psychological interventions and physical therapies is discussed. Intra-oral appliances will be covered in a dedicated article later in this series.

CPD/Clinical Relevance: Clinicians should have both an understanding and appreciation for the non-surgical management options available to patients diagnosed with TMD.

Article

In Part 1 of this series, the aetiology and diagnosis of temporomandibular disorders (TMD) were discussed.1 Owing to the complexity of TMD, its management can present challenges. Although general evidence-based non-surgical guidelines exist for TMD, it is important to highlight that there is not one approach for all, and specific patient factors need to be considered.2 Therapeutic interventions should be patient-centred and monitored over time for change.3 The aims of this article are to discuss the non-surgical management options that are available, other than appliance therapy, for patients with TMD, to present the evidence base to support their use and to provide some practical suggestions for primary care dental practitioners to adopt.

Physiotherapy is frequently chosen for the management of TMD due to its reversibility and relative low cost compared to other treatment modalities. The therapeutic goals are to decrease pain, aid muscle relaxation, reduce muscular hyperactivity, improve function and to improve quality of life.4 Physiotherapists provide bespoke rehabilitation programmes for each patient depending on the outcome of a comprehensive biopsychosocial assessment.5

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