title: The changing focus of chronic temporomandibular disorders: management within a hospital-based, multidisciplinary pain centre.
abstract: Despite evidence to the contrary, many dentists still cling to outdated beliefs and practices regarding the aetiology and management of chronic temporomandibular disorders (TMDs). Chronic pain disorders require a multidisciplinary approach with a strong focus on psychological factors. Treatment failures and relapse are likely if such factors are not considered. Most chronic temporomandibular pain problems are extracapsular and of myofascial origin. Mechanistic or invasive treatments in such cases may be inappropriate and can cause harm. Conservative measures used for other types of chronic muscular pain are generally recommended. All health practitioners who deal with acute and chronic pain should be aware of recent major advances in the understanding of pain mechanisms. Along with psychosocial considerations, these must be emphasised in undergraduate and continuing education programmes.
authors.affiliation: Auckland Regional Pain Service, Auckland Hospital.
authors.forename: P A
authors.initials: PA
authors.lastname: Foreman
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004497:Education, Dental; D004498:Education, Dental, Continuing; D005157:Facial Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008410:Masticatory Muscles / Q000503:physiopathology; D018710:Pain Clinics; D012008:Recurrence; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy; D017211:Treatment Failure