Continuing Education for Dentists

NTI-tss & headaches

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When a patient presents with chronic orofacial pain, clinicians tend to think of TMJ, a rather meaningless term. Temporomandibular disorders (TMD), first suggested by Bell (1982), is a better, though still problematic, term for musculoskeletal disorders of the masticatory system.

A developing consensus is that this term leaves much to be desired (Laskin, 2008) because, as Nitzan et al (2004) state: ' ... TMD became a commitment-free term frequently used by clinicians and researchers to avoid well-defined differential diagnoses.'

The problem of classification of orofacial pain can be traced back to the 'lateral hand-off of responsibility from otolaryngologists (ENT Physicians) to dentists' (Greene, 2006), when in 1934 Costen erroneously concluded that the facial pain problems he saw were caused by dental and orthopedic misalignment of the cranium and jaw structures.

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