Are Temporomandibular Joint Disorders (TMDs) Self-Limiting?

There has been much contorversary and confusion over the years regarding the question as to whether temporomandibular joint (TMJ) disorders are self-limiting or not.  This is a complicated issue of great concern to both patients and healthcare providers.  The authors in the study below have found some prior studies attempting to address this issue to contain "major methodological limitiations."  Their study investigated 274 consecutive patients in five diagnostic categories involving TMDs and a 25 patient comparison group.  Their research supports the hypothesis that TMDs are not self-limiting and that active treatments result in statistically significant symptom improvement while untreated patients did not.

Wexler GB, McKinney MW, Temporomandibular Treatment Outcomes within Five Diagnostic Categories, Jour of Craniomandib Practice, (17)1: 30-37, 1999


This study of temporomandibular disorder (TMD) treatment outcomes examines 274 consecutive patients in five diagnostic categories and a 25 patient comparison group to determine relative levels of symptom improvement. Employing a psychometric outcome measure, the TMJ Scale, it was found that patients receiving active TMD treatments manifest statistically significant symptom improvements. Untreated patients reported minor and statistically insignificant symptom variations. Patients with intracapsular TM joint dysfunctions exhibited higher levels of improvement in pain and other TMD symptoms than patients presenting with primarily muscle symptoms. This research supports the hypothesis that TMDs are not self-limiting and require active treatment interventions. It is suggested that some studies cited to show that TMDs are self-limiting have major methodological limitations, relying upon unvalidated and subjective assessments of symptom levels. This research also outlines a procedure for TMD practitioners to measure treatment efficacy and the relative effectiveness of differing treatment modalities in a valid, consistent and unbiased manner.

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