AADR TMD Policy Statement Revision
Approved by AADR Council 3/3/2010.
For citation: http://www.aadronline.org/i4a/pages/index.cfm?pageid=3465 followed by date.
The AADR recognizes that temporomandibular disorders (TMDs) encompass a group of
musculoskeletal and neuromuscular conditions that involve the temporomandibular joints(TMJs), the masticatory muscles, and all associated tissues. The signs and symptoms associatedwith these disorders are diverse, and may include difficulties with chewing, speaking, and otherorofacial functions. They also are frequently associated with acute or persistent pain, and thepatients often suffer from other painful disorders (comorbidities). The chronic forms of TMD
pain may lead to absence from or impairment of work or social interactions, resulting in anoverall reduction in the quality of life.
Based on the evidence from clinical trials as well as experimental and epidemiologic studies:1) It is recommended that the differential diagnosis of TMDs or related orofacial pain conditions
should be based primarily on information obtained from the patient's history, clinicalexamination, and when indicated TMJ radiology or other imaging procedures. The choice ofadjunctive diagnostic procedures should be based upon published, peer-reviewed data showing
diagnostic efficacy and safety. However, the consensus of recent scientific literature about
currently available technological diagnostic devices for TMDs is that, except for various imaging
modalities, none of them shows the sensitivity and specificity required to separate normal
subjects from TMD patients or to distinguish among TMD subgroups. Currently, standard
medical diagnostic or laboratory tests that are used for evaluating similar orthopedic,rheumatological and neurological disorders may also be utilized when indicated with TMD
patients. In addition, various standardized and validated psychometric tests may be used to assess
the psychosocial dimensions of each patient's TMD problem.
2) It is strongly recommended that, unless there are specific and justifiable indications to thecontrary, treatment of TMD patients initially should be based on the use of conservative,reversible and evidence-based therapeutic modalities. Studies of the natural history of many
TMDs suggest that they tend to improve or resolve over time. While no specific therapies havebeen proven to be uniformly effective, many of the conservative modalities have proven to be atleast as effective in providing symptomatic relief as most forms of invasive treatment. Because
those modalities do not produce irreversible changes, they present much less risk of producing
harm. Professional treatment should be augmented with a home care program, in which patientsare taught about their disorder and how to manage their symptoms.

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