title: A critical review of Dr. Charles S. Greene's article titled "Managing the Care of Patients with Temporomandibular Disorders: a new Guideline for Care" and a revision of the American Association for Dental Research's 1996 policy statement on temporomandibular disorders, approved by the AADR Council in March 2010, published in the Journal of the American Dental Association September 2010.
abstract: Dr. Charles Greene's article, "Managing the Care of Patients with TMDs A New Guideline for Care," and the American Association for Dental Research's (AADR) 2010 Policy Statement on Temporomandibular Disorders, published in the Journal of the American Dental Association (JADA) September 2010, are reviewed in detail. The concept that all temporomandibular disorders (TMDs) should be lumped into one policy statement for care is inappropriate. TMDs are a collection of disorders that are treated differently, and the concept that TMDs must only be managed within a biopsychosocial model of care is inappropriate. TMDs are usually a musculoskeletal orthopedic disorder, as defined by the AADR. TMD orthopedic care that is peer-reviewed and evidence-based is available and appropriate for some TMDs. Organized dentistry, including the American Dental Association, and mainstream texts on TMDs, support the use of orthopedics in the treatment of some TMDs. TMDs are not psychological or social disorders. Informed consent requires that alternative care is discussed with patients. Standard of care is a legal concept that is usually decided by a court of law and not decided by a policy statement, position paper, guidelines or parameters of care handed down by professional organizations. The 2010 AADR Policy Statement on TMD is not the standard of care in the United States. Whether a patient needs care for a TMD is not decided by a diagnostic test, but by whether the patient has significant pain, dysfunction and/or a negative change in quality of life from a TMD and they want care. Some TMDs need timely invasive and irreversible care.
authors.affiliation: Oral and Maxillofacial Surgery Department at Vanderbilt University School of Medicine.
authors.forename: H Clifton
authors.initials: HC
authors.lastname: Simmons
mesh_terms: D001182:Arthroscopy; D001706:Biopsy; D059350:Chronic Pain / Q000175:diagnosis; D000529:Complementary Therapies; D017271:Craniomandibular Disorders / Q000175:diagnosis / Q000628:therapy; D018865:Dental Research; D003952:Diagnostic Imaging; D055094:Evidence-Based Dentistry; D005157:Facial Pain / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007258:Informed Consent; D020380:Needs Assessment; D019637:Orthopedic Procedures; D018024:Peer Review, Health Care; D017410:Practice Guidelines as Topic / Q000592:standards*; D011788:Quality of Life / Q000523:psychology; D059039:Standard of Care; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D009626:Terminology as Topic