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Why the "See also: Fibromyalgia"? Can the resident expert/whoever added that (if available) please explain the relation I'm not seeing, and add that to the article? MCOTWnom
all very interesting, but why the first person?
Also, a definition of the disorder would be helpful. --AxelBoldt---- To my knowledge this is a "syndrome" and therefore the definitions consists of symptoms... but a list of symptoms is also missing. RoseParks
The article on the Temporomandibular joint mentions the "disc" many times, and describes its displacement. The disc is not mentioned ONCE in this article. Something isn't right there. -- Tedtoal ( talk) 04:21, 15 February 2012 (UTC)--
definitely not a disease...TMJ is most often caused by chronic tooth-grinding or jaw clenching. It is characterized by chronic headaches and and can lead to a misalignment of the jaw. JHK
But it is a syndrome and at times a disabling syndrome. And, there is no proof that it comes from tooth-grinding(bruxism) - that I know of. Do you have a reputable source for such a cause? More interesting is that the overwhelming majority of diagnosed patients are female. RoseParks
And what is a temporomandibular joint anyway? The joint that attaches the jaw to the rest of the head? -- Paul Drye
Recent edit adde to list of symptoms "Popping or clicking when the jaws are opened" and "Popping or clicking when attempting to chew".
David Ruben Talk 14:58, 8 March 2006 (UTC)
This is where "TMD" is an annoying term (pain dysfunction syndrome is much more accurate and less confusing). Are we talking about temporomandibular disorders generally (if so then yes, TMJ subluxation is a disorder that affects the TMJ), or are we talking about temporomandibular disorders as in the topic of this page, that syndrome created by a lumping together of different disorders that affect the TMJ and that have a similar set of signs and symptoms, then arguably no, unless TMJ subluxation causes (i) pain (ii) limitation of mandibular movement and/or (iii) joint noises. I think the problem with TMJ subluxation is that the joint is too loose and the condyle pops out of the articular fossa, although it stays within its capsule. What the difference between subluxation and TMJ dislocation is I am not 100% sure- maybe something to do with subluxation easily returning and dislocation not, or maybe something to do with the capsule. Subluxation also sounds like it is managed differently, with elastic IMF rather than with all these TMD therapies. I can't find any good source about TMJ subluxation, and I am not sure that it should be included on this page if the signs and symptoms do not fit with the 3 classic TMD ones above. It might be better discussed on the dislocation of jaw or even hypermobility pages... Lesion ( talk) 17:57, 30 May 2013 (UTC)
Does this article count as a stub?
Thank you for your question. It does not qualify as a "stub" under the present wiki-definition. Therefore I have removed the stub category from the article. pat8722 16:08, 23 April 2006 (UTC)
I am not terribly offended, but I feel the need to express this to you. When it comes to facts about specialized fields, I understand that some knowledge taken for granted by the professionals may sound completely foreign to the general public. Since you are unaware of arthrocentesis, I am assuming you do not have close ties to the dental profession. If you have seen my user page, you would note that my main objective here is in the dental field, and I guess I take for granted that flushing out the TMJ as one avenue of treatment just makes sense. Nonetheless, I feel it would have been considerate to keep a "citation needed" tag to the sentence so that us dental-minded wikipedians would have noted that there was a request for a reference for the information. Otherwise, it would be more difficult to notice that the information was missing from the article, and thus more difficult to add a reference to that specific piece of information. Again, I realize you may not know much about the dental profession, but it may be easier next time there is info you want verified to leave a message on a talk page of someone who is a dentist. Thanks. - Dozenist talk 01:54, 22 May 2006 (UTC)
I think you misunderstand, I am saying that next time using the "citation needed" tag may be more beneficial for the article since the correct information can be included in the article while at the same time bring up the need for a citation. Otherwise, the information may be lost for a while until someone at a later date realizes the omission. This is even a more logical thing to do especially since you say that you ARE "aware of arthrocentesis"--- deleting something you know to be true only because there is no citation would be better handled by just adding a tag saying a citation is warranted. Further, I interpret Davidruben's talk page to say he is a physician, NOT a dentist. And for the record, I did not originally add the statement as you can see here. - Dozenist talk 03:07, 22 May 2006 (UTC)
Well, I am disappointed that it appears you are hostile to any effort I make to improve the article. I will not feel it necessary to defend my actions to you, even after you say arthrocentesis makes no sense and the treatment is "bizarre" yet later claim that you were actually "aware of arthrocentesis" and the real reason you deleted pertinent information you knew to be correct was that there was no citation and no context. Well, I have looked at that section of the article and it seems to have perfect context to me since it is one form of treatment. And we all know that different treatments are necessary since most disorders have different causes. Also, if you are an oral and maxillofacial surgeon that treats tmd, I am confused why you would dismiss a less obtrusive treatment than most surgical treatments for tmd, but as I said I will no longer attempt to defend my actions to you since you appear to dismiss them and belittle them. - Dozenist talk 03:46, 22 May 2006 (UTC)
Just because you do not understand the different etiologic factors that may cause tmd, the health community does not have to change the way it treats tmd. Arthrocentesis treats tmd when certain factors cause tmd. Furthermore, guiding the mandible back to the correct position will not treat tmd when certain factors are involved. All this makes sense since frequently tmd is more complicated than a dislocated shoulder and also because the tmj functions differently than the shoulder joint. If you are really interested in learning, then just ask, but I have no incentive to help you if you criticize and complain about something you do not understand. - Dozenist talk 19:47, 28 May 2006 (UTC)
You continue to make false assumptions and mindless insults. You do not put arthrocentesis into the article as a "cure for TMJD" because you know I would delete it, as being unsourced/unsourcable, in that it is not true - and you know it, even as a "24 year old dental student". The comparison to a dislocated shoulder is entirely apt, for reasons I have stated, and you have not countered. You would know all this if you were an expert in the field. You evidence worse than ignorance. pat8722 00:32, 5 June 2006 (UTC)
I agree totally with Pat8722. Successful treatment of TMD requires the treating of it's causitive factors and not it's symptoms. Connective tissue scarring, thinning, perforations and bone spicules of the joint spaces do not develop without a functional pathology elsewhere. Patients with normal occlusion and posture do not develop arthritic changes in the TMJs. Causitive factors of TMD include breating issues as a young child leading to imporper tongue position to accomodate mouth breathing, improper restorative dentistry, tooth loss or breakdown, some orthodontic care, and ascending postural issues that may arise from trauma or injury of the vertebral column (MVAs). Since successful treatment of TMD requires a multidisiplinary approach a unilateral surgical approach will ulitmately fail. Joint damage will resolve without an invasive surgery once the balanced physiologic function is returned to the system with proper orthotic care of the patient's occlusion and cervical alignment of the vertebral colunm with the skull. Arthrocentesis is a tool used by oral surgeons who are faced with helping the patient and who's only tool is a scaple. This does not speak to an unprofessionalism of the Oral Surgeons, but to the general inability of the general dental profession to diagnose and treat TMD. Dr. Curtis Westersund 15:00, 26 July 2006 (UTC)
The fact remains that the craniomandibular articulation is the most complex in the body, because it not only includes a pair of diarthrodial joints but the occlusion of the dentition. This is an immensely difficult area to study. A lot of experts conclude at the moment that TMJDS may not be a distinct clinical entity because of the presence of crepitus and other indicators of joint pathology in a significant proportion of the population who don't complain of pain. Crepitus and deviation really indicators of a disease? Is there any loss of function with crepitus and/or deviation? I wouldn't think so. Why do some people develop pain and others not? A central and unsatisfactorily answered question in my opinion. In fact, there is very little evidence (in the line of interventional studies) supporting the influence of the occlusion on the TMJs, despite its obvious (to me anyway) role. Science is not always intuitive, however and a sound theory is not always sound science. Significantly, there is little evidence supporting the use of occlusal splint therapy (hard or soft) in the treatment of myofascial pain and TMJDS, but these are well known and well accepted treatment modalities.
With respect to arthrocentesis, two of the consultant oral surgeons in my training hospital used to tell us anectdotes of TMJ's that were 'loosened' with arthroscopy alone. A relief of symptoms was experienced by the patient. I would deem this a success because this treatment achieved the dual goals of pain relief and restoration of function.This procedure was reserved for patients for which every other suspected pathology and treatment had been explored. But we deal with evidence not anectdotes. I just use this as an example to shed light on the fact that there is no such thing as NPOV because there is so little evidence to support one thing over another, as far as I am aware. So good luck writing an article! Dr-G - Illigetimi nil carborundum est. 02:20, 18 August 2006 (UTC)
With regards to posture, I would actually be interested in evidence related to postural influence on TMD. I only ask because I know very little of the TMJ myself and I have heard mention of this before. My only problem with this theory is that the mandible is related to only the skull and the hyoid bone and no other osseous structures. I am aware that soft tissue can influence mandibular positioning, but only when the mandible is at rest, or in it's postural position. I fail to see how extraoral soft tissue can influence a solid MIP. If you can direct me to scholarly artcles or texts, I would much appreciate it, as I have an (small) interest in cranio-sacral and alternative therapies in dentistry and also in mainstream neuromuscular dentistry, which did not form a large part of my undergraduate curriculum. (I went to Japan and experienced an oral medicine pain management clinic and they showed us some interesting results using acupuncture and other traditional doctrines in the management of myofascial and psychogenic pain.) Dr-G - Illigetimi nil carborundum est. 02:03, 18 August 2006 (UTC)
I would like to thank Dr. Ruben for his contribution. There is no need for intellectual snobbery here. We need as much help as can be got on these articles. I'm sure Dr. Ruben has more experience treating TMJD than other contributers to this article. As far as associated symptoms of backache, yes patients may have associated symptoms of backache and headache, but there is very little or no evidence to suggest a link at this time. Wide ranging musculoskeletal problems are symptoms of stress, and therefore may not be biomechanically or immunologically related. This is why Dr. Ruben has had success with using low dose antidepressants for treatment of pain (this is a well-studied and oft-used treatment modality for psychogenic facial pain). Therefore, no-one is wrong here. I think you must learn to accept that there may be other points of view than your own pat8722, and that this disease is woefully understudied and poorly understood by medical science! No single point of view is greater than another in this, and my experience is that both specialists and GDPs use their clinical intuition to do something that they either think will work or that they have experienced working in other patients. See my above comments re: arthrocentesis for further expansion on this idea. I think that citation is important here, but understand and expect to find that in this field contradiction exists even in the literature and so all points must be accommodated equally, if they have a citation. With regard to your questions Dr. Ruben, MedLine. Sorry I'm just too lazy to dig for articles that possibly may not exist or are severely outdated. This area as I say is woefully understudied particularly in the areas that you point out. Prevalence in the population depends on your definition of TMJDS (whether pain is a defining characteristic or not). Tricyclics - I had never heard of them being used for TMJD/S but it seems pharmacologically sound. However, as far as I am aware, low doses do not produce anxiolytic and antidepressant effects, which may also be beneficial in the treatment of TMJD/S particularly in light of the contribution of stress. I'm sure some of these questions may be answerable with studies. I'll have a look. Parafunctional habits refer to bruxism (grinding) which tends to be an unconscious action which engages the masticatory system to produce habits that may cause damage to teeth, TMJ and muscles of mastication because of development of excessive forces, repetitive strain and oxygen deficit through overuse and engorgement of muscles. Read that masticatory system article, particularly the piece (which I will rewrite when I dig out my old notes) on mastication motor programme. It explains the massive central contribution to this subset of diseases and why some dentists believe that some myofascial and TMJD treatment lies outside the realm of dentistry, and should belong to neurologists, psychiatrists and psychologists. What is not in dispute is that at the very least, it is a multidisciplinary approach that is required. Dr-G - Illigetimi nil carborundum est. 12:24, 18 August 2006 (UTC)
Twice now, Jersyko has reverted my edits of sourced material. The information I have added to the article is undisputedlytrue. "TMJ Syndrome: The Overlooked Diagnosis, A. Richard, D. D. S. Goldman Virginia McCullough" is a reliable source for the information that meets all Wiki citation criteria, and was duly cited. Unless you have a source to counter my source, please do not delete this material, as to do so is Wikipedia:Vandalism. pat8722 19:26, 25 June 2006 (UTC)
"TMJ Syndrome: The Overlooked Diagnosis, A. Richard, D. D. S. Goldman Virginia McCullough" meets all wikipedia sourcing criteria. Wikipedia: sources at "What sources to cite" merely says "PREFER... peer-reviewed English-language sources.", not that every published source must be peer-reviewed (the VAST majority of sources, cited in wikipedia or otherwise, are NOT peer-reviewed). As it is undisputable that "backache" is one of the symptoms of TMJD, and as you have not cited a source to dispute it, the most you could reasonably want to do is to add a tag of "source needed", but even that is not justified under the wikipedia rules, as the present source is all that is needed. Also, as you removed the source for "stiffness in the back and shoulders", but not the symptom, what was your source for leaving that one, only, in? pat8722 13:32, 9 July 2006 (UTC)
I've recently seem to have been part of an revert-war over the symptoms of TMJD so its time to try and discuss how best to structure this section. I've listed the individual aspects of this version change so that discussion may follow.
I have gone through the material in a textbook of mine to add refs and detail to the section on signs and symptoms. The heading of the section was changed to signs and symptoms because signs are an objective finding and symptoms are subjectives ones--- both of which are discussed in the section. Also, I went ahead and avoided making a list, since I remember seeing somewhere in wikipedia that prose is preferable to lists. The order in which the topics in this section is arranged was mirrored from the order of the textbook. Most of the information that was previously there should remain in one form or another. A bit of it might no longer be present because the textbook made no mention of it in the chapter I read, which was pretty extensive. Lastly, Pat8722, I ask you again to not attack fellow wikipedians. I think David Ruben has shown a willingness to work with you by adding citations. - Dozenist talk 01:44, 24 July 2006 (UTC)
References
(1) The TMJ:The Overlooked Diagnosis book was written in the 1980s, bears no evidence of peer review, and contains no citations to scientific articles, studies, or journals. Thus, if using the information from this book does not violate WP:RS and WP:V, it at least is of questionable value in an encyclopedia article written in 2006. (2) The source cited by Dozenist in his expansion of the article is a widely used, peer reviewed, fully cited, and current dentistry textbook. Its status as a reliable source is unassailable. (3) The insertion of the list in the article, which now also contains detailed information on the variety of signs and symptoms, disrupts the article's flow and is duplicative. For what it's worth, I find the article's current breakdown of signs and symptoms into three main groups much more easy to read and informative than a bulleted list, though this is merely an opinion. In any event, since this information is taken from a reliable source and the list is not, the list is inappropriate. (4) Referring to Wikipedia:Vandalism every time the list is re-added is not, in any way, going to aid our discussion here, and it is untrue that any edits related to this list amount to vandalism. If you sincerely believed otherwise, Pat8722, you would have filed a vandalism report. Let's have a rational discussion instead of devolving to the use of implied, empty threats. · j·e·r·s·y·k·o talk · 21:21, 30 July 2006 (UTC)
3RR does not grant a user the automatic right to disrupt wikipedia process by reverting any and all other editors up to 3 times in a day - such deliberate action (see "Third revert for today, see talk page. See you next Sunday") amounts, I beleive, to further example of Gaming of the three revert rule. WP:AN/3RR therefore raised re Pat8722. David Ruben Talk 04:06, 31 July 2006 (UTC)
Not looking for a dispute here, but I was wondering if there was someone who could provide more information on the different classes of TMJ disorder? My PCP just told me my jaw was slightly misaligned due to probable TMJ disorder and referred me to a dentist. When I made the appointment they asked if I was "class 1", I told them I guess that's what I was going to them to find out...
I'm guessing my problem developed from grinding and biting habits I have due to OCD and anxiety disorders, so if anyone has information showing a relationship between the two I'd like to know about that as well.
thanks!
Polyphonickat
18:36, 5 May 2007 (UTC)
Could semi-major (one tooth was completely horizontal and set in deep into the jaw bone) impacted wisdom tooth surgery promote TMJ? —Preceding unsigned comment added by 69.120.93.246 ( talk) 11:54, 9 July 2007
I would hazard a guess that, like me, most people accessing this article will be sufferers or possible sufferers from this condition rather than experts. From that perspective, it seems to me that three issues are far from clear, and that clarification would be of great benefit:
1. From the article, it would appear that TMD comprises the incorrect movement of the mandible in a fore-and-aft direction - but can this also occur laterally, i.e. in such a way that the jaw displaces to the left and/or to the right? My condition seems to have begun as the former (characterised by clicks and pops, as described here), but has now become the latter (characterised by numbness/temporary seizing of the jaw).
2. Again from a lay perspective, what about consequences of TMD? It occurs to me - and I must stress that it occurs to me simply as a lay person - that this disorder could trap not only nerves but also blood vessels. If so, what further symptoms could result?
3. Could TMD result from difficult wisdom tooth extraction?
(In my case, the wisdom tooth had to be cut in half laterally, using some kind of disc cutter, after which the front half was removed. Removal of the back half required a further cutting in half of the remaining tooth in the same way).
It could be that these issues might be answered by an expert contributor, and/or that there could be a reference to a related wikipedia article addressing these issues, if such exists. This could be a great help to non-expert readers. —Preceding unsigned comment added by Vvmodel ( talk • contribs) 22:40, 29 February 2008 (UTC)
1. TMD may be caused by "incorrect use" (I'd rather say "incorrect movement"), e.g. bruxism and other parafunctional activities, pen chewing, nail biting etc, but there are many other theories as to why what causes TMD. Yes bruxism and other parafunctions can be in all sorts of patterns, some people just clench without grinding, others grind on the back teeth, maybe backwards and forwards maybe side to side, and others grind on the front teeth, again possibly side to side or maybe front to back. The significance- pain in different muscles (e.g. in side to side grinding pain will be in the muscles that move the jaw side to side), and clenching only may cause tooth wear of a different pattern to tooth wear caused by grinding. I reworked the bruxism page and this is all discussed there better than it was.
2. Each TMJ is encased within a fibrous joint capsule, which doesn't really have loose nerves and blood vessels inside- at least some of the internal tissues of this capsule do not have any blood vessels inside them. Having said that, if there is anterior disc displacement, then the softer tissues that attach the disc to the back of the joint can be pulled into the position where the disc should be. The attachment tissues are not designed to take the load of the joint like the disc is, so in a way this could be thought of as something getting trapped. I've added a new "prognosis" section to discuss the consequences of TMD, but I am having trouble filling it with anything solid due to lack of sources.
3. Addressed this now a bit in the article with a source, but it could do with expansion. Dental treatment generally, if the mouth is open for a long time, but tooth extraction especially because forces are put on the jaw. I guess wisdom tooth extraction might cause more TMJ damage potentially since they tend to take longer to extract than other teeth- means more time with mouth open and more time where forces (and possibly greater forces than with other teeth) are being put on the jaw and transferred to the TMJs. If there is a source that supports "wisdom tooth extraction more likely to cause TMD than extraciton of other teeth" this would be good to include. Lesion ( talk) 18:19, 30 May 2013 (UTC)
For the last few days, I have found it painful to open my mouth very far. Also when I first wake up, I find it painful to close my teeth together, but this goes away after I force them closed a couple times. Do I have this disorder? —Preceding unsigned comment added by 138.87.219.217 ( talk • contribs)
Not enough info for diagnosis, but if I were to guess, I would say no. More likely that your wisdom teeth are giving you trouble and you are suffering trismus. However this is a guess and in no way constitutes a diagnosis. Dr-G - Illigetimi non carborundum est. 18:46, 13 September 2007 (UTC)
This statement is in the introduction: "Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry, neurology, physical therapy, and psychology — there are a variety of treatment approaches." There are no citations for this statement, and no references to many of the areas in the Treatment section. I especially feel to see how psychology comes into play, unless to deal with possible depression from the disorder. However, I don't believe that is direct enough to be mentioned, though a short mention may be warranted with a citation in another area of the article. This is only my opinion, and so I'm not willing to be bold here. - Cyborg Ninja 22:07, 23 January 2009 (UTC)
Temporomandibular_joint_disorder#Relocating_a_dislocated_jaw sounds a lot like a how-to medical treatment guide. Is this really appropriate for Wikipedia, especially since it has no citations as to its origin, veracity, or safety? -- Mr.98 ( talk) 11:12, 29 October 2009 (UTC)
This article seems to have been tampered with by persons with financial interests in a given treatment. CranioSacral therapy supposedly "taps into natural rhythms," which is utter poppycock to anyone with scientific or medical training, and the only citations for Feldenkrais methods employing a "unique" understanding of neurology led to a site selling the treatment! —Preceding unsigned comment added by 128.192.90.110 ( talk) 17:41, 14 February 2011 (UTC)
I see this has been discussed before ...
The article doesn't just seem like a manual it is providing direct instructions to readers about what they should and shouldn't do in the first and second person.
It is also very poorly sourced and (I suspect) is coming from the perspective of only one specialism/approach to the problem.
Whilst it can be hard to get citations for all sorts of different aspects of the condition and its treatment, it is definitely not on to talk about the benefits, controversies and risks without finding a reference to back it up.
I think much of the article should be removed and reintroduced as and when someone can do so in a more encyclopedic fashion. —Preceding unsigned comment added by 90.195.131.21 ( talk) 17:25, 28 March 2010 (UTC)
I've added a couple more books, both with google previews. Have at 'em! LeadSongDog come howl! 19:43, 21 October 2010 (UTC)
This looks like a product, not a modality. It is mentioned four times in this article. And the article it links to has one reference to medical sources. —Preceding unsigned comment added by 72.187.99.79 ( talk) 03:28, 22 April 2011 (UTC)
I came in to make exactly the same comment. I think the most blatant part was the "and can be tried for up to three weeks at no cost" bit. I mean, it's like someone LITERALLY ripped the section from an advert. I'm inclined to take it down. — Preceding unsigned comment added by 71.243.112.118 ( talk) 03:00, 22 June 2011 (UTC)
I don't claim to be an expert here, but why is there no mention of chiropractic in relation to this particular disorder? I thought the lead was hinting that many disciplines are concerned here... but mainly the dental and surgeon practices seem to be discussed in the present article, and little of the neuro or bone doctors. The obvious smack to the face is mentioned, but I thought chiropractors dealt with a lot of these joint and bone things. I like to saw logs! ( talk) 06:23, 3 June 2011 (UTC)
"There is some indication that chiropractic treatment may be helpful for some cases of temporomandibular disorders based on positive case reports 13,19,38 and the improvement of all nine patients in a small prospective case series.11" [2]
"The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults." [3]
According to the article on Arthrocentesis, it is not the same as joint irrigation. Arthrocentesis means to extract fluid from the joint. Joint irrigation means to inject fluid into the joint. Irrespective of the effectiveness of various treatments listed under "Long-term approach", or whether these paragraphs are organized poorly or well, the correct term as presented under "Long-term approach" is Joint irrigation, not Arthrocentesis (joint irrigation). Friendly Person ( talk) 20:22, 29 October 2011 (UTC)
Somewhere along the line, the article lost many citations to Moseby that were present in this version from 2006. If someone's feeling industrious, there's room for restoring them. LeadSongDog come howl! 17:03, 17 October 2012 (UTC)
Im trying to help/treat my TMJ, and having to go to over a dozen different pages to find out what thrown out words mean is frustrating beyond belief. — Preceding unsigned comment added by 71.57.53.3 ( talk) 00:36, 4 November 2012 (UTC)
I used all the search terms I found for this disorder on pubmed (crude, but better than nothing imo)
Search terms | # pubmed hits |
---|---|
"temporomandibular joint dysfunction" | 4806 |
"temporomandibular joint dysfunction syndrome" | 4560 |
"temporomandibular joint pain dysfunction syndrome" | 76 |
"temporomandibular pain dysfunction syndrome" | 19 |
"temporomandibular joint disorder" | 154 |
"temporomandibular joint syndrome" | 109 |
"temporomandibular dysfunction syndrome" | 11 |
"temporomandibular dysfunction" | 319 |
"temporomandibular disorder" | 770 |
"temporomandibular syndrome" | 18 |
"Pain dysfunction syndrome" | 386 |
"facial arthromyalgia" | 9 |
"myofacial pain dysfunction syndrome" | 19 |
"craniomandibular dysfunction" | 141 |
"myofacial pain dysfunction" | 34 |
"masticatory myalgia" | 12 |
"mandibular dysfunction" | 273 |
"Costen syndrome" | 6 |
"Costen's syndrome" | 74 |
There are 4 or 5 cochrane reviews dedicated to this topic [4]. We should be using the highest quality available evidence instead of outdated and/or primary sources. Lesion ( talk) 00:49, 3 May 2013 (UTC)
Per WP:MEDRS, the following may be unsuitable sources and need removal, ideally without losing the content they currently support, instead supporting it with suitable secondary sources. Lesion ( talk) 11:25, 22 May 2013 (UTC)
We have a "Temporomandibular joints" section which really is about the normal anatomy and a "teeth" section which really discusses causes, although it is not placed in the causes section. I think it would be good to have a short "Relevant anatomy and physiology" section. At least one reader above stated that they disliked having to visit other pages so much to understand this article. However, since we already) have (or at least should have) focused articles on the aspects of normal anatomy and physiology of relevance here ( mastication, temporomandibular joint, occlusion, muscles of mastication, etc), then the need for such a section is called into question.
Frankly, there is no such thing as "neuromuscular dentistry"...by this I mean it is not a recognized subspecialty of dentistry in any country that I know of. Occlusal adjustments are no longer considered appropriate treatments for TMD by the vast majority of dentists or other clinicians who manage TMD. There is no evidence base and multiple prominent sources have discouraged the continuing use of occlusal adjustments in TMD. As to TENS for TMD, at least this is not likely to cause any permanent damage (although local skin reactions can develop where the electrodes are placed), but I wonder if there is really any evidence for this?
Lesion (
talk)
16:43, 27 May 2013 (UTC)
My problem with the above page is how it presents "neuromuscular dentistry" as the gold standard therapy for TMD with no other discussion of other mainstream treatment options. After chewing through a lot of high quality TMD sources, I am confident to state that "neuromuscular dentistry" for TMD is a fringe theory and should be presented with due weight, not its own article of non point of view bullshit.
Lesion (
talk)
16:54, 27 May 2013 (UTC)
I feel the edit by Flsurfgirl places undue weight on a surgical procedure that is very rarely carried out for TMJ-PDS. It is also entirely related to the USA, and therefore of no interest to most readers. Matthew Ferguson 57 ( talk) 01:59, 4 January 2015 (UTC)
For the section on management, I have an idea from my own experience, which of course I can't directly add to the article. I think I have a mild case of TMD. At my dentist's suggestion, I went to a softer diet. For some folks, a fully soft diet is best (eg baby food and smoothies). I have found by experience that I don't have to go that far, but I do need to avoid crunchy foods like raw carrots and heavy-chewy foods like crusty bread. Also, I need to eat with smaller bites, more slowly, and with care. I would be very surprised if there isn't a good ref. for ideas in this category for people with TMD. However, I don't know what the ref. is, so I'll let some other Wikipedian find it and write it up. Oaklandguy ( talk) 21:51, 17 November 2015 (UTC)
I've had a quick look at the info box and it says TMJ falls under the "speciality" of "gastroenterology". I'd assume the speciality is neuromuscular, I'm pretty certain than it's nothing to do with the digestive system though. I've been unable to edit the article as I can't see the "speciality" section, if someone could do so it'd be of benefit to the article. Arkhangelsk185 ( talk) 20:43, 12 December 2015 (UTC)
This is the preferred UK and US term according to http://www.nhs.uk/conditions/temporomandibular-joint-disorder/Pages/Introduction.aspx and http://emedicine.medscape.com/article/1143410-overview -- Espoo ( talk) 18:05, 3 February 2016 (UTC)
To refer to this condition as TMJ is incorrect. TMJ is the abbreviation for the joint itself. Matthew Ferguson ( talk)
To make the claim that it is known as lock jaw one needs a good reference.
This is not a good source Is Lockjaw the Same as TMD?. In fact it look fairly spam like.
Doc James ( talk · contribs · email) 14:02, 4 February 2016 (UTC)
For more information see these articles: https://www.google.com/search?newwindow=1&safe=active&rlz=1C1CHWL_enIR734IR734&q=Mastoidite&spell=1&sa=X&ved=0ahUKEwjmzp_v0NrTAhXIApoKHbqmCXIQBQgiKAA&biw=1366&bih=589 — Preceding unsigned comment added by 5.78.143.218 ( talk) 06:28, 6 May 2017 (UTC)
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Why the "See also: Fibromyalgia"? Can the resident expert/whoever added that (if available) please explain the relation I'm not seeing, and add that to the article? MCOTWnom
all very interesting, but why the first person?
Also, a definition of the disorder would be helpful. --AxelBoldt---- To my knowledge this is a "syndrome" and therefore the definitions consists of symptoms... but a list of symptoms is also missing. RoseParks
The article on the Temporomandibular joint mentions the "disc" many times, and describes its displacement. The disc is not mentioned ONCE in this article. Something isn't right there. -- Tedtoal ( talk) 04:21, 15 February 2012 (UTC)--
definitely not a disease...TMJ is most often caused by chronic tooth-grinding or jaw clenching. It is characterized by chronic headaches and and can lead to a misalignment of the jaw. JHK
But it is a syndrome and at times a disabling syndrome. And, there is no proof that it comes from tooth-grinding(bruxism) - that I know of. Do you have a reputable source for such a cause? More interesting is that the overwhelming majority of diagnosed patients are female. RoseParks
And what is a temporomandibular joint anyway? The joint that attaches the jaw to the rest of the head? -- Paul Drye
Recent edit adde to list of symptoms "Popping or clicking when the jaws are opened" and "Popping or clicking when attempting to chew".
David Ruben Talk 14:58, 8 March 2006 (UTC)
This is where "TMD" is an annoying term (pain dysfunction syndrome is much more accurate and less confusing). Are we talking about temporomandibular disorders generally (if so then yes, TMJ subluxation is a disorder that affects the TMJ), or are we talking about temporomandibular disorders as in the topic of this page, that syndrome created by a lumping together of different disorders that affect the TMJ and that have a similar set of signs and symptoms, then arguably no, unless TMJ subluxation causes (i) pain (ii) limitation of mandibular movement and/or (iii) joint noises. I think the problem with TMJ subluxation is that the joint is too loose and the condyle pops out of the articular fossa, although it stays within its capsule. What the difference between subluxation and TMJ dislocation is I am not 100% sure- maybe something to do with subluxation easily returning and dislocation not, or maybe something to do with the capsule. Subluxation also sounds like it is managed differently, with elastic IMF rather than with all these TMD therapies. I can't find any good source about TMJ subluxation, and I am not sure that it should be included on this page if the signs and symptoms do not fit with the 3 classic TMD ones above. It might be better discussed on the dislocation of jaw or even hypermobility pages... Lesion ( talk) 17:57, 30 May 2013 (UTC)
Does this article count as a stub?
Thank you for your question. It does not qualify as a "stub" under the present wiki-definition. Therefore I have removed the stub category from the article. pat8722 16:08, 23 April 2006 (UTC)
I am not terribly offended, but I feel the need to express this to you. When it comes to facts about specialized fields, I understand that some knowledge taken for granted by the professionals may sound completely foreign to the general public. Since you are unaware of arthrocentesis, I am assuming you do not have close ties to the dental profession. If you have seen my user page, you would note that my main objective here is in the dental field, and I guess I take for granted that flushing out the TMJ as one avenue of treatment just makes sense. Nonetheless, I feel it would have been considerate to keep a "citation needed" tag to the sentence so that us dental-minded wikipedians would have noted that there was a request for a reference for the information. Otherwise, it would be more difficult to notice that the information was missing from the article, and thus more difficult to add a reference to that specific piece of information. Again, I realize you may not know much about the dental profession, but it may be easier next time there is info you want verified to leave a message on a talk page of someone who is a dentist. Thanks. - Dozenist talk 01:54, 22 May 2006 (UTC)
I think you misunderstand, I am saying that next time using the "citation needed" tag may be more beneficial for the article since the correct information can be included in the article while at the same time bring up the need for a citation. Otherwise, the information may be lost for a while until someone at a later date realizes the omission. This is even a more logical thing to do especially since you say that you ARE "aware of arthrocentesis"--- deleting something you know to be true only because there is no citation would be better handled by just adding a tag saying a citation is warranted. Further, I interpret Davidruben's talk page to say he is a physician, NOT a dentist. And for the record, I did not originally add the statement as you can see here. - Dozenist talk 03:07, 22 May 2006 (UTC)
Well, I am disappointed that it appears you are hostile to any effort I make to improve the article. I will not feel it necessary to defend my actions to you, even after you say arthrocentesis makes no sense and the treatment is "bizarre" yet later claim that you were actually "aware of arthrocentesis" and the real reason you deleted pertinent information you knew to be correct was that there was no citation and no context. Well, I have looked at that section of the article and it seems to have perfect context to me since it is one form of treatment. And we all know that different treatments are necessary since most disorders have different causes. Also, if you are an oral and maxillofacial surgeon that treats tmd, I am confused why you would dismiss a less obtrusive treatment than most surgical treatments for tmd, but as I said I will no longer attempt to defend my actions to you since you appear to dismiss them and belittle them. - Dozenist talk 03:46, 22 May 2006 (UTC)
Just because you do not understand the different etiologic factors that may cause tmd, the health community does not have to change the way it treats tmd. Arthrocentesis treats tmd when certain factors cause tmd. Furthermore, guiding the mandible back to the correct position will not treat tmd when certain factors are involved. All this makes sense since frequently tmd is more complicated than a dislocated shoulder and also because the tmj functions differently than the shoulder joint. If you are really interested in learning, then just ask, but I have no incentive to help you if you criticize and complain about something you do not understand. - Dozenist talk 19:47, 28 May 2006 (UTC)
You continue to make false assumptions and mindless insults. You do not put arthrocentesis into the article as a "cure for TMJD" because you know I would delete it, as being unsourced/unsourcable, in that it is not true - and you know it, even as a "24 year old dental student". The comparison to a dislocated shoulder is entirely apt, for reasons I have stated, and you have not countered. You would know all this if you were an expert in the field. You evidence worse than ignorance. pat8722 00:32, 5 June 2006 (UTC)
I agree totally with Pat8722. Successful treatment of TMD requires the treating of it's causitive factors and not it's symptoms. Connective tissue scarring, thinning, perforations and bone spicules of the joint spaces do not develop without a functional pathology elsewhere. Patients with normal occlusion and posture do not develop arthritic changes in the TMJs. Causitive factors of TMD include breating issues as a young child leading to imporper tongue position to accomodate mouth breathing, improper restorative dentistry, tooth loss or breakdown, some orthodontic care, and ascending postural issues that may arise from trauma or injury of the vertebral column (MVAs). Since successful treatment of TMD requires a multidisiplinary approach a unilateral surgical approach will ulitmately fail. Joint damage will resolve without an invasive surgery once the balanced physiologic function is returned to the system with proper orthotic care of the patient's occlusion and cervical alignment of the vertebral colunm with the skull. Arthrocentesis is a tool used by oral surgeons who are faced with helping the patient and who's only tool is a scaple. This does not speak to an unprofessionalism of the Oral Surgeons, but to the general inability of the general dental profession to diagnose and treat TMD. Dr. Curtis Westersund 15:00, 26 July 2006 (UTC)
The fact remains that the craniomandibular articulation is the most complex in the body, because it not only includes a pair of diarthrodial joints but the occlusion of the dentition. This is an immensely difficult area to study. A lot of experts conclude at the moment that TMJDS may not be a distinct clinical entity because of the presence of crepitus and other indicators of joint pathology in a significant proportion of the population who don't complain of pain. Crepitus and deviation really indicators of a disease? Is there any loss of function with crepitus and/or deviation? I wouldn't think so. Why do some people develop pain and others not? A central and unsatisfactorily answered question in my opinion. In fact, there is very little evidence (in the line of interventional studies) supporting the influence of the occlusion on the TMJs, despite its obvious (to me anyway) role. Science is not always intuitive, however and a sound theory is not always sound science. Significantly, there is little evidence supporting the use of occlusal splint therapy (hard or soft) in the treatment of myofascial pain and TMJDS, but these are well known and well accepted treatment modalities.
With respect to arthrocentesis, two of the consultant oral surgeons in my training hospital used to tell us anectdotes of TMJ's that were 'loosened' with arthroscopy alone. A relief of symptoms was experienced by the patient. I would deem this a success because this treatment achieved the dual goals of pain relief and restoration of function.This procedure was reserved for patients for which every other suspected pathology and treatment had been explored. But we deal with evidence not anectdotes. I just use this as an example to shed light on the fact that there is no such thing as NPOV because there is so little evidence to support one thing over another, as far as I am aware. So good luck writing an article! Dr-G - Illigetimi nil carborundum est. 02:20, 18 August 2006 (UTC)
With regards to posture, I would actually be interested in evidence related to postural influence on TMD. I only ask because I know very little of the TMJ myself and I have heard mention of this before. My only problem with this theory is that the mandible is related to only the skull and the hyoid bone and no other osseous structures. I am aware that soft tissue can influence mandibular positioning, but only when the mandible is at rest, or in it's postural position. I fail to see how extraoral soft tissue can influence a solid MIP. If you can direct me to scholarly artcles or texts, I would much appreciate it, as I have an (small) interest in cranio-sacral and alternative therapies in dentistry and also in mainstream neuromuscular dentistry, which did not form a large part of my undergraduate curriculum. (I went to Japan and experienced an oral medicine pain management clinic and they showed us some interesting results using acupuncture and other traditional doctrines in the management of myofascial and psychogenic pain.) Dr-G - Illigetimi nil carborundum est. 02:03, 18 August 2006 (UTC)
I would like to thank Dr. Ruben for his contribution. There is no need for intellectual snobbery here. We need as much help as can be got on these articles. I'm sure Dr. Ruben has more experience treating TMJD than other contributers to this article. As far as associated symptoms of backache, yes patients may have associated symptoms of backache and headache, but there is very little or no evidence to suggest a link at this time. Wide ranging musculoskeletal problems are symptoms of stress, and therefore may not be biomechanically or immunologically related. This is why Dr. Ruben has had success with using low dose antidepressants for treatment of pain (this is a well-studied and oft-used treatment modality for psychogenic facial pain). Therefore, no-one is wrong here. I think you must learn to accept that there may be other points of view than your own pat8722, and that this disease is woefully understudied and poorly understood by medical science! No single point of view is greater than another in this, and my experience is that both specialists and GDPs use their clinical intuition to do something that they either think will work or that they have experienced working in other patients. See my above comments re: arthrocentesis for further expansion on this idea. I think that citation is important here, but understand and expect to find that in this field contradiction exists even in the literature and so all points must be accommodated equally, if they have a citation. With regard to your questions Dr. Ruben, MedLine. Sorry I'm just too lazy to dig for articles that possibly may not exist or are severely outdated. This area as I say is woefully understudied particularly in the areas that you point out. Prevalence in the population depends on your definition of TMJDS (whether pain is a defining characteristic or not). Tricyclics - I had never heard of them being used for TMJD/S but it seems pharmacologically sound. However, as far as I am aware, low doses do not produce anxiolytic and antidepressant effects, which may also be beneficial in the treatment of TMJD/S particularly in light of the contribution of stress. I'm sure some of these questions may be answerable with studies. I'll have a look. Parafunctional habits refer to bruxism (grinding) which tends to be an unconscious action which engages the masticatory system to produce habits that may cause damage to teeth, TMJ and muscles of mastication because of development of excessive forces, repetitive strain and oxygen deficit through overuse and engorgement of muscles. Read that masticatory system article, particularly the piece (which I will rewrite when I dig out my old notes) on mastication motor programme. It explains the massive central contribution to this subset of diseases and why some dentists believe that some myofascial and TMJD treatment lies outside the realm of dentistry, and should belong to neurologists, psychiatrists and psychologists. What is not in dispute is that at the very least, it is a multidisciplinary approach that is required. Dr-G - Illigetimi nil carborundum est. 12:24, 18 August 2006 (UTC)
Twice now, Jersyko has reverted my edits of sourced material. The information I have added to the article is undisputedlytrue. "TMJ Syndrome: The Overlooked Diagnosis, A. Richard, D. D. S. Goldman Virginia McCullough" is a reliable source for the information that meets all Wiki citation criteria, and was duly cited. Unless you have a source to counter my source, please do not delete this material, as to do so is Wikipedia:Vandalism. pat8722 19:26, 25 June 2006 (UTC)
"TMJ Syndrome: The Overlooked Diagnosis, A. Richard, D. D. S. Goldman Virginia McCullough" meets all wikipedia sourcing criteria. Wikipedia: sources at "What sources to cite" merely says "PREFER... peer-reviewed English-language sources.", not that every published source must be peer-reviewed (the VAST majority of sources, cited in wikipedia or otherwise, are NOT peer-reviewed). As it is undisputable that "backache" is one of the symptoms of TMJD, and as you have not cited a source to dispute it, the most you could reasonably want to do is to add a tag of "source needed", but even that is not justified under the wikipedia rules, as the present source is all that is needed. Also, as you removed the source for "stiffness in the back and shoulders", but not the symptom, what was your source for leaving that one, only, in? pat8722 13:32, 9 July 2006 (UTC)
I've recently seem to have been part of an revert-war over the symptoms of TMJD so its time to try and discuss how best to structure this section. I've listed the individual aspects of this version change so that discussion may follow.
I have gone through the material in a textbook of mine to add refs and detail to the section on signs and symptoms. The heading of the section was changed to signs and symptoms because signs are an objective finding and symptoms are subjectives ones--- both of which are discussed in the section. Also, I went ahead and avoided making a list, since I remember seeing somewhere in wikipedia that prose is preferable to lists. The order in which the topics in this section is arranged was mirrored from the order of the textbook. Most of the information that was previously there should remain in one form or another. A bit of it might no longer be present because the textbook made no mention of it in the chapter I read, which was pretty extensive. Lastly, Pat8722, I ask you again to not attack fellow wikipedians. I think David Ruben has shown a willingness to work with you by adding citations. - Dozenist talk 01:44, 24 July 2006 (UTC)
References
(1) The TMJ:The Overlooked Diagnosis book was written in the 1980s, bears no evidence of peer review, and contains no citations to scientific articles, studies, or journals. Thus, if using the information from this book does not violate WP:RS and WP:V, it at least is of questionable value in an encyclopedia article written in 2006. (2) The source cited by Dozenist in his expansion of the article is a widely used, peer reviewed, fully cited, and current dentistry textbook. Its status as a reliable source is unassailable. (3) The insertion of the list in the article, which now also contains detailed information on the variety of signs and symptoms, disrupts the article's flow and is duplicative. For what it's worth, I find the article's current breakdown of signs and symptoms into three main groups much more easy to read and informative than a bulleted list, though this is merely an opinion. In any event, since this information is taken from a reliable source and the list is not, the list is inappropriate. (4) Referring to Wikipedia:Vandalism every time the list is re-added is not, in any way, going to aid our discussion here, and it is untrue that any edits related to this list amount to vandalism. If you sincerely believed otherwise, Pat8722, you would have filed a vandalism report. Let's have a rational discussion instead of devolving to the use of implied, empty threats. · j·e·r·s·y·k·o talk · 21:21, 30 July 2006 (UTC)
3RR does not grant a user the automatic right to disrupt wikipedia process by reverting any and all other editors up to 3 times in a day - such deliberate action (see "Third revert for today, see talk page. See you next Sunday") amounts, I beleive, to further example of Gaming of the three revert rule. WP:AN/3RR therefore raised re Pat8722. David Ruben Talk 04:06, 31 July 2006 (UTC)
Not looking for a dispute here, but I was wondering if there was someone who could provide more information on the different classes of TMJ disorder? My PCP just told me my jaw was slightly misaligned due to probable TMJ disorder and referred me to a dentist. When I made the appointment they asked if I was "class 1", I told them I guess that's what I was going to them to find out...
I'm guessing my problem developed from grinding and biting habits I have due to OCD and anxiety disorders, so if anyone has information showing a relationship between the two I'd like to know about that as well.
thanks!
Polyphonickat
18:36, 5 May 2007 (UTC)
Could semi-major (one tooth was completely horizontal and set in deep into the jaw bone) impacted wisdom tooth surgery promote TMJ? —Preceding unsigned comment added by 69.120.93.246 ( talk) 11:54, 9 July 2007
I would hazard a guess that, like me, most people accessing this article will be sufferers or possible sufferers from this condition rather than experts. From that perspective, it seems to me that three issues are far from clear, and that clarification would be of great benefit:
1. From the article, it would appear that TMD comprises the incorrect movement of the mandible in a fore-and-aft direction - but can this also occur laterally, i.e. in such a way that the jaw displaces to the left and/or to the right? My condition seems to have begun as the former (characterised by clicks and pops, as described here), but has now become the latter (characterised by numbness/temporary seizing of the jaw).
2. Again from a lay perspective, what about consequences of TMD? It occurs to me - and I must stress that it occurs to me simply as a lay person - that this disorder could trap not only nerves but also blood vessels. If so, what further symptoms could result?
3. Could TMD result from difficult wisdom tooth extraction?
(In my case, the wisdom tooth had to be cut in half laterally, using some kind of disc cutter, after which the front half was removed. Removal of the back half required a further cutting in half of the remaining tooth in the same way).
It could be that these issues might be answered by an expert contributor, and/or that there could be a reference to a related wikipedia article addressing these issues, if such exists. This could be a great help to non-expert readers. —Preceding unsigned comment added by Vvmodel ( talk • contribs) 22:40, 29 February 2008 (UTC)
1. TMD may be caused by "incorrect use" (I'd rather say "incorrect movement"), e.g. bruxism and other parafunctional activities, pen chewing, nail biting etc, but there are many other theories as to why what causes TMD. Yes bruxism and other parafunctions can be in all sorts of patterns, some people just clench without grinding, others grind on the back teeth, maybe backwards and forwards maybe side to side, and others grind on the front teeth, again possibly side to side or maybe front to back. The significance- pain in different muscles (e.g. in side to side grinding pain will be in the muscles that move the jaw side to side), and clenching only may cause tooth wear of a different pattern to tooth wear caused by grinding. I reworked the bruxism page and this is all discussed there better than it was.
2. Each TMJ is encased within a fibrous joint capsule, which doesn't really have loose nerves and blood vessels inside- at least some of the internal tissues of this capsule do not have any blood vessels inside them. Having said that, if there is anterior disc displacement, then the softer tissues that attach the disc to the back of the joint can be pulled into the position where the disc should be. The attachment tissues are not designed to take the load of the joint like the disc is, so in a way this could be thought of as something getting trapped. I've added a new "prognosis" section to discuss the consequences of TMD, but I am having trouble filling it with anything solid due to lack of sources.
3. Addressed this now a bit in the article with a source, but it could do with expansion. Dental treatment generally, if the mouth is open for a long time, but tooth extraction especially because forces are put on the jaw. I guess wisdom tooth extraction might cause more TMJ damage potentially since they tend to take longer to extract than other teeth- means more time with mouth open and more time where forces (and possibly greater forces than with other teeth) are being put on the jaw and transferred to the TMJs. If there is a source that supports "wisdom tooth extraction more likely to cause TMD than extraciton of other teeth" this would be good to include. Lesion ( talk) 18:19, 30 May 2013 (UTC)
For the last few days, I have found it painful to open my mouth very far. Also when I first wake up, I find it painful to close my teeth together, but this goes away after I force them closed a couple times. Do I have this disorder? —Preceding unsigned comment added by 138.87.219.217 ( talk • contribs)
Not enough info for diagnosis, but if I were to guess, I would say no. More likely that your wisdom teeth are giving you trouble and you are suffering trismus. However this is a guess and in no way constitutes a diagnosis. Dr-G - Illigetimi non carborundum est. 18:46, 13 September 2007 (UTC)
This statement is in the introduction: "Because the disorder transcends the boundaries between several health-care disciplines — in particular, dentistry, neurology, physical therapy, and psychology — there are a variety of treatment approaches." There are no citations for this statement, and no references to many of the areas in the Treatment section. I especially feel to see how psychology comes into play, unless to deal with possible depression from the disorder. However, I don't believe that is direct enough to be mentioned, though a short mention may be warranted with a citation in another area of the article. This is only my opinion, and so I'm not willing to be bold here. - Cyborg Ninja 22:07, 23 January 2009 (UTC)
Temporomandibular_joint_disorder#Relocating_a_dislocated_jaw sounds a lot like a how-to medical treatment guide. Is this really appropriate for Wikipedia, especially since it has no citations as to its origin, veracity, or safety? -- Mr.98 ( talk) 11:12, 29 October 2009 (UTC)
This article seems to have been tampered with by persons with financial interests in a given treatment. CranioSacral therapy supposedly "taps into natural rhythms," which is utter poppycock to anyone with scientific or medical training, and the only citations for Feldenkrais methods employing a "unique" understanding of neurology led to a site selling the treatment! —Preceding unsigned comment added by 128.192.90.110 ( talk) 17:41, 14 February 2011 (UTC)
I see this has been discussed before ...
The article doesn't just seem like a manual it is providing direct instructions to readers about what they should and shouldn't do in the first and second person.
It is also very poorly sourced and (I suspect) is coming from the perspective of only one specialism/approach to the problem.
Whilst it can be hard to get citations for all sorts of different aspects of the condition and its treatment, it is definitely not on to talk about the benefits, controversies and risks without finding a reference to back it up.
I think much of the article should be removed and reintroduced as and when someone can do so in a more encyclopedic fashion. —Preceding unsigned comment added by 90.195.131.21 ( talk) 17:25, 28 March 2010 (UTC)
I've added a couple more books, both with google previews. Have at 'em! LeadSongDog come howl! 19:43, 21 October 2010 (UTC)
This looks like a product, not a modality. It is mentioned four times in this article. And the article it links to has one reference to medical sources. —Preceding unsigned comment added by 72.187.99.79 ( talk) 03:28, 22 April 2011 (UTC)
I came in to make exactly the same comment. I think the most blatant part was the "and can be tried for up to three weeks at no cost" bit. I mean, it's like someone LITERALLY ripped the section from an advert. I'm inclined to take it down. — Preceding unsigned comment added by 71.243.112.118 ( talk) 03:00, 22 June 2011 (UTC)
I don't claim to be an expert here, but why is there no mention of chiropractic in relation to this particular disorder? I thought the lead was hinting that many disciplines are concerned here... but mainly the dental and surgeon practices seem to be discussed in the present article, and little of the neuro or bone doctors. The obvious smack to the face is mentioned, but I thought chiropractors dealt with a lot of these joint and bone things. I like to saw logs! ( talk) 06:23, 3 June 2011 (UTC)
"There is some indication that chiropractic treatment may be helpful for some cases of temporomandibular disorders based on positive case reports 13,19,38 and the improvement of all nine patients in a small prospective case series.11" [2]
"The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults." [3]
According to the article on Arthrocentesis, it is not the same as joint irrigation. Arthrocentesis means to extract fluid from the joint. Joint irrigation means to inject fluid into the joint. Irrespective of the effectiveness of various treatments listed under "Long-term approach", or whether these paragraphs are organized poorly or well, the correct term as presented under "Long-term approach" is Joint irrigation, not Arthrocentesis (joint irrigation). Friendly Person ( talk) 20:22, 29 October 2011 (UTC)
Somewhere along the line, the article lost many citations to Moseby that were present in this version from 2006. If someone's feeling industrious, there's room for restoring them. LeadSongDog come howl! 17:03, 17 October 2012 (UTC)
Im trying to help/treat my TMJ, and having to go to over a dozen different pages to find out what thrown out words mean is frustrating beyond belief. — Preceding unsigned comment added by 71.57.53.3 ( talk) 00:36, 4 November 2012 (UTC)
I used all the search terms I found for this disorder on pubmed (crude, but better than nothing imo)
Search terms | # pubmed hits |
---|---|
"temporomandibular joint dysfunction" | 4806 |
"temporomandibular joint dysfunction syndrome" | 4560 |
"temporomandibular joint pain dysfunction syndrome" | 76 |
"temporomandibular pain dysfunction syndrome" | 19 |
"temporomandibular joint disorder" | 154 |
"temporomandibular joint syndrome" | 109 |
"temporomandibular dysfunction syndrome" | 11 |
"temporomandibular dysfunction" | 319 |
"temporomandibular disorder" | 770 |
"temporomandibular syndrome" | 18 |
"Pain dysfunction syndrome" | 386 |
"facial arthromyalgia" | 9 |
"myofacial pain dysfunction syndrome" | 19 |
"craniomandibular dysfunction" | 141 |
"myofacial pain dysfunction" | 34 |
"masticatory myalgia" | 12 |
"mandibular dysfunction" | 273 |
"Costen syndrome" | 6 |
"Costen's syndrome" | 74 |
There are 4 or 5 cochrane reviews dedicated to this topic [4]. We should be using the highest quality available evidence instead of outdated and/or primary sources. Lesion ( talk) 00:49, 3 May 2013 (UTC)
Per WP:MEDRS, the following may be unsuitable sources and need removal, ideally without losing the content they currently support, instead supporting it with suitable secondary sources. Lesion ( talk) 11:25, 22 May 2013 (UTC)
We have a "Temporomandibular joints" section which really is about the normal anatomy and a "teeth" section which really discusses causes, although it is not placed in the causes section. I think it would be good to have a short "Relevant anatomy and physiology" section. At least one reader above stated that they disliked having to visit other pages so much to understand this article. However, since we already) have (or at least should have) focused articles on the aspects of normal anatomy and physiology of relevance here ( mastication, temporomandibular joint, occlusion, muscles of mastication, etc), then the need for such a section is called into question.
Frankly, there is no such thing as "neuromuscular dentistry"...by this I mean it is not a recognized subspecialty of dentistry in any country that I know of. Occlusal adjustments are no longer considered appropriate treatments for TMD by the vast majority of dentists or other clinicians who manage TMD. There is no evidence base and multiple prominent sources have discouraged the continuing use of occlusal adjustments in TMD. As to TENS for TMD, at least this is not likely to cause any permanent damage (although local skin reactions can develop where the electrodes are placed), but I wonder if there is really any evidence for this?
Lesion (
talk)
16:43, 27 May 2013 (UTC)
My problem with the above page is how it presents "neuromuscular dentistry" as the gold standard therapy for TMD with no other discussion of other mainstream treatment options. After chewing through a lot of high quality TMD sources, I am confident to state that "neuromuscular dentistry" for TMD is a fringe theory and should be presented with due weight, not its own article of non point of view bullshit.
Lesion (
talk)
16:54, 27 May 2013 (UTC)
I feel the edit by Flsurfgirl places undue weight on a surgical procedure that is very rarely carried out for TMJ-PDS. It is also entirely related to the USA, and therefore of no interest to most readers. Matthew Ferguson 57 ( talk) 01:59, 4 January 2015 (UTC)
For the section on management, I have an idea from my own experience, which of course I can't directly add to the article. I think I have a mild case of TMD. At my dentist's suggestion, I went to a softer diet. For some folks, a fully soft diet is best (eg baby food and smoothies). I have found by experience that I don't have to go that far, but I do need to avoid crunchy foods like raw carrots and heavy-chewy foods like crusty bread. Also, I need to eat with smaller bites, more slowly, and with care. I would be very surprised if there isn't a good ref. for ideas in this category for people with TMD. However, I don't know what the ref. is, so I'll let some other Wikipedian find it and write it up. Oaklandguy ( talk) 21:51, 17 November 2015 (UTC)
I've had a quick look at the info box and it says TMJ falls under the "speciality" of "gastroenterology". I'd assume the speciality is neuromuscular, I'm pretty certain than it's nothing to do with the digestive system though. I've been unable to edit the article as I can't see the "speciality" section, if someone could do so it'd be of benefit to the article. Arkhangelsk185 ( talk) 20:43, 12 December 2015 (UTC)
This is the preferred UK and US term according to http://www.nhs.uk/conditions/temporomandibular-joint-disorder/Pages/Introduction.aspx and http://emedicine.medscape.com/article/1143410-overview -- Espoo ( talk) 18:05, 3 February 2016 (UTC)
To refer to this condition as TMJ is incorrect. TMJ is the abbreviation for the joint itself. Matthew Ferguson ( talk)
To make the claim that it is known as lock jaw one needs a good reference.
This is not a good source Is Lockjaw the Same as TMD?. In fact it look fairly spam like.
Doc James ( talk · contribs · email) 14:02, 4 February 2016 (UTC)
For more information see these articles: https://www.google.com/search?newwindow=1&safe=active&rlz=1C1CHWL_enIR734IR734&q=Mastoidite&spell=1&sa=X&ved=0ahUKEwjmzp_v0NrTAhXIApoKHbqmCXIQBQgiKAA&biw=1366&bih=589 — Preceding unsigned comment added by 5.78.143.218 ( talk) 06:28, 6 May 2017 (UTC)