TMD current concepts: 1. An update

This, the first of two articles, addresses current concepts of aetiology, diagnosis and management of temporomandibular disorders (TMD).The aim is to direct the reader toward a more evidence-based approach; specific treatment regimes can be accessed elsewhere.The concept of these articles is to encourage the reader to think about the wider ramifications of TMD, with specific relevance to their management in general dental practice.This article addresses current controversial concepts, including occlusion, tinnitus, hearing, speech defects and bruxism.The second part addresses the need for imaging and explores treatment concepts. TMD management in general dental practice is widely regarded as being a contentious subject, with several differing and often diametrically opposed viewpoints being aired, not only in relation to aetiology and diagnosis but also in relation to treatment.This uncertainty often prompts the dentist to refer for secondary care. Another recurring issue is the lack of adequate remuneration in the general dental services for management of the patients, for example by splint therapy. CLINICAL RELEVANCE: Sound, up-to-date knowledge in the treatment of TMD is essential.