Temporomandibular Disorders A Problem-Based Approach

THE AUTHORS

DR ROBIN J.M. GRAY BDS, MDS, PhD, MFGDP, Specialist in Oral Surgery; Formerly Senior Lecturer, Co-ordinator of TMD Clinical Teaching and Research Services, Department of Dental Medicine and Surgery, University Dental Hospital of Manchester; Formerly Principal of Grays Dental Care, General Dental Practice; Director of Manchester Dental Specialists

DR M. ZIAD AL-ANI BDS, MSc, PhD, MFDS, RCS(Ed), FHEA, University Teacher, Glasgow Dental Hospital and School, Glasgow

Acknowledgements.

1 About the Book.

About temporomandibular disorders: what is a ‘TMD’?

2 Clinical Aspects of Anatomy, Function, Pathology and Classification.

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

The intra-articular disc (meniscus).

The bones of the temporomandibular joint.

Mandibular (jaw/masticatory) muscles.

Classification and Pathology.

Further reading.

3 Articulatory System Examination.

Examination of the temporomandibular joints.

Mandibular (masticatory) muscle tenderness.

Signs of bruxism.

Further reading.

4 I’ve Got ‘TMJ’!

History.

Examination.

Special tests.

Differential diagnosis.

Management.

Further reading.

5 I’ve Got a Clicking Joint.

History.

Examination.

Other special tests.

Treatment.

The patient journey.

Further reading.

6 I’ve Got a Locking Joint.

History.

Examination.

Diagnosis.

Treatment.

TMJ locking.

Further reading.

7 I’ve Got a Grating Joint.

Examination.

Diagnosis.

Treatment.

Final treatment plan.

Further reading.

8 You’ve Changed My Bite.

History.

Examination.

Treatment.

Discussion.

Further reading.

9 I’ve Got Pain in My Face.

History.

Examination.

Differential diagnosis.

Treatment.

Questions to ask patients regarding pain in general.

Further reading.

10 I’ve Got a Dislocated Jaw.

Examination.

Likely diagnoses.

Management.

Further reading.

11 My Teeth Are Worn.

History.

Examination.

Diagnosis.

Treatment.

Important considerations in tooth surface loss.

Further reading.

12 I’ve Got a Headache.

Examination.

Radiographs.

Articulatory system exam.

Likely diagnosis.

Management.

Patient journey.

Further reading.

13 I’ve Got Whiplash.

Examination.

Record keeping.

Are TMD and whiplash related?

Likely diagnosis.

Management.

Further reading.

14 What’s of Use to Me in Practice?

Counselling and reassurance.

Drug therapy.

Physiotherapy.

Splint therapy.

Mouth prop.

Occlusal adjustments.

Radiographs.

Further referral.

Further reading.

15 You and the Lawyer.

Case scenario 1: note and record keeping.

Case scenario 2: a medical report request.

Case scenario 3: a disgruntled patient.

Further reading.

16 The Referral Letter.

Details.

History.

Request.

Further reading.

17 How to Make a Splint.

How do you make a stabilisation splint?

Fitting a stabilisation splint.

How do you make an anterior repositioning splint?

Further reading.

18 Patient Information.

Stabilisation splint.

Anterior repositioning splint.

General advice for patients with a TMD.

Exercise programme for patients with TMD.

19 Glossary of Terms.

20 Short Answer Questions.

Index.

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