Many TMD “Specialists” Aren’t So Well Informed

Richard Gawel


Some dental offices advertise themselves on the Internet as “specialists” in managing temporomandibular disorders (TMDs). The actual expertise of these offices may be questionable, however, according to investigators at the Tufts University School of Dental Medicine and the Virginia Commonwealth School of Dentistry

Using Google and “TMD specialist in” followed by the names of different states, researchers at the school found 255 dental providers advertising TMD management services.

Two thirds of these providers were general dentists. The rest included oral surgeons, orthodontists, and prosthodontists, as well as oral medicine and orofacial pain management providers.

According to the researchers, 66.7% of these websites attributed TMDs to occlusal problems or malocclusion. Also, 54.5% of the providers suggested treating occlusal problems or malocclusion to alleviate TMDs.

“The association of maloclussion to TMDs is not supported by research or literature,” said Bhavik Desai, DMD, PhD, assistant professor in the division of oral medicine with the department of diagnostic sciences at the school. “Hence, such a claim is inaccurate.”

Reversible, conservative treatment modalities are recommended for the management of patients with TMDs instead, Desai added.

Also, 38.8% of the sites labeled TMDs as a single disorder instead of a heterogeneous group of disorders that can affect musculature, bone, joints, and nerves—another inaccurate claim, Desai said.

The researchers speculate that the information on these websites might not be regularly updated, leading to these inaccuracies. Also, they say, dental school curricula might not adequately emphasize the diagnosis and management of TMDs.

Patients should be concerned about the doctors they select, while practitioners should be prepared to deal with misinformed patients, the researchers said. The researchers also suggest that dentists keep abreast of current peer-reviewed literature for the diagnosis and management of TMDs.

“The ADA statement paper recommending TMDs be treated reversibly and conservatively, keeping in mind that there is a biopsychosocial component to the condition, is a good guideline for accurate information that may be incorporated into one’s website,” Desai said.

The study, “How Accurate Is Information About Diagnosis and Management of Temporomandibular Disorders on Dentist Websites?” was published by Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology.

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