I am writing this letter on behalf of the Executive of the Ontario Association of Orthodontists (OAO) to voice our concern with respect to the above named articles that appeared in the June 2005 edition.
Orthodontists have historically been involved in the diagnosis and treatment for patients with TMD. We have recognized the multi-factorial aspects in both the diagnosis and treatment of these problems. There should always be an interaction between the various specialties and general dentists in the management of these complex dysfunctions.
We fully support the recommendations of the Royal College of Dental Surgeons of Ontario in their Guidelines for the Diagnosis and Management of Temporo-mandibular Disorders. These guidelines encourage practitioners to practise conservative, reversible treatment procedures before the irreversible. Practitioners treating patients with TMD should not adopt cookbook approaches to TMD problems. The science related to the treatment of TMD must be evidence based. ‘Claims’ as to the successful treatment of TMD by the methods proposed in the above referenced articles are at best speculative.
References to the work of distinguished researchers in the field of orthodontics were applied out of context to serve the purpose of the authors.
Psychological, physiotherapeutic, pharmacological, reversible splint therapies, and surgical modalities all play a role in the management of TMD. There are no routine quick cures for all complaints. Patients need a full diagnosis that reflects the multi-factorial nature of this common disorder. We should all work as a team with the general practitioner and related specialties in managing these problems for our patients.
Michael Patrician DDS, Dip. Ortho., FICD, FADI
Toronto
Vice-President Ontario Association of Orthodontists
