Dogma

There is a shift to treating TMD in terms of psychological factors and pain physiology.

Occlusal role

Long believed to be dominant cause now gradually being completely debunked. Information, reassurance, analgesics for pain relief, and jaw exercises will help majority of TMD patients.
Placebo splint covering only hard palate is largely as effective as occlusal splint. Proposed mechanisms for effects of intraoral appliances (excluding debunked occlusal)

  1. Occlusal disengagement
  2. Neurophysiological effect on masticatory system
  3. Change of vertical
  4. Change of caput-fossa relation
  5. Cognitive awareness of harmful behaviors
  6. Stress absorber
  7. Placebo effect

Treatment recommendations

  1. Conservative, reversible, and evidence based therapeutic modalities (not occlusal adjustments)
  2. Home care program

 

J Prosthodont Res. 2009 Jan Critical review of some dogmas in prosthodontics. Carlsson

Acta Odontol Scand. 2010 Nov Some dogmas related to prosthodontics, temporomandibular disorders and occlusion. Carlsson

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