In their February JADA article, "Predoctoral Teaching of Temporomandibular Disorders: A Survey of U.S. and Canadian Dental Schools" (
JADA 2007;138[2]:231–7
), Drs. Gary Klasser and Charles Greene say "there are no standardized curricula or requirements to establish guidelines on the topics associated with [temporomandibular joint dysfunction, or] TMD," even after a series of conferences covering a period of 10 years, from 1990 to 2000. Perhaps this is a good thing.
It is almost impossible to find a consensus of thought on even the most basic understanding of the temporomandibular joint. There is disagreement among and between anatomists and maxillofacial surgeons as to the normal form and alignment of intracapsular structures. There is disagreement among those who emphasize a need to recognize and address specific types of physical temporomandibular joint derangements and those who are interested only in relieving pain by means of palliative therapies. There is "evidence-based" outcome research that talks about the majority but fails to address the suffering minority.
TMD definitely can be a multifactorial disease. It is a disease of the masticatory system. It is a disease that is more properly handled by dentists as the primary manager, with adjunctive therapies provided by other professionals, if required.
Unfortunately, provincialism and politics in TMD research is preventing dentistry from getting to the truth related to the condition’s anatomy, diagnosis and therapy.
