Folks,
Around here, TMD cases seem to be shuffled among many specialists. The different paths of diagnosis and treatment seem to be related to where the patient first sought treatment. If they have approached thier medical doctor, they usually get to see a neurologist and end up with a stack of CT scans and radiographs. They get treated medically at first until they finally run into someone who recognizes the problem. It's usually an ENT who treats them with excersizes and drugs and perhaps surgery in rare cases. Some find a chiropractor and have some relief. These patients sometimes start there because they really don't have tooth pain. If they do get to a dentist, they get shuffled around missdignosed and end up in any of the dental specialties as a last resort trying to rule out wisdom teeth or endodontic problems. Those who recognize the problem seem to send them to the periodontists around us who have a really good handle on occlusion and have all the right stuff to make appliances and follow these people, dictating what restorative, endodontic, and ortho needs they may require. There are no TMD specialists, I think, because this problem is not one that one knows they have at first, and goes undiagnosed until they finally find someone way down the line who knows what they have and also how to treat it themselves. I have found dozens of them who have ended up in my office after years of medical treatment and horror stories of trips to Cleveland Clinic and the like. Some have lost thier jobs over it. I get them out of trouble and send them to the folks who have the best chance of managing this long term. Here it's the periodontists.
