RETOOLING FOR ACCURACY

With tremendous gratitude, I say once again how privileged I was to be an invited guest of the American Academy of Craniofacial Pain at their 28th Annual convention in San Diego on July 26th through the 28th.  I learned so much.

For the last three to four years we have been publishing information on symptoms that were categorized as Parkinson’s, but could be symptoms coming from TMJ (Temporomandibular Joint) and/or TMD (Temporomandibular Joint Disorder).  From the AACP (American Academy of Craniofacial Pain) convention, I learned that the more accurate name for this discussion should be CRANIO MANDIBULAR DISORDER (CMD).

Craniomandibular disorders (CMD) includes different musculoskeletal conditions that involve the masticatory muscles, the temporomandibular (TM) joints and the associated structures.

The various clinical conditions are characterized by similar signs and symptoms:

• Pain in the preauricular (in front of the ear) area, TM joints or masticatory muscles;
• Limitation or deviation in mandibular range of motion;
• TM joint sounds (clicking and cracking) during mandibular function.

Other common complaints include:  difficulty swallowing, headache, neckache, faceache, earache, tinnitus (is there evidence for this?), ear fullness, and perceived hearing loss.

Prevalence of CMD is very high.  Seventy-five percent of the general populations exhibit at least one sign of dysfunction (joint noise or deviation on opening) and 33% have at least one symptom (pain).

International classification divides CMD in 3 main categories:

• Muscular pain, with or without functional limitation;
• Disc displacement (i.e. alteration of the normal position of the disc between the mandibular condyle and the eminence);
• Inflammatory and/or degenerative condition of the TM joint.

Within the next few months we will get more involved with describing CMD and practice areas of highly trained and equipped dentists limited by license to treating disorders which affect the head and neck, and the areas limited by license to Medical Doctors including Movement Disorder Specialists.  Perhaps it is time that the twain meet.

“Never the twain shall meet.”  (Literary) Something that you say when two things or people are so different that they can never exist together or agree with each other.