Controversies in temporomandibular joint disorder.
The multifactorial origin of TMJ dysfunctions has led to confusion about etiology and treatment. Because of the many disciplines involved in treatment, differences in terminology have surfaced. Standardization of terminology may reduce some of the controversy over the etiology and incidence of TMJ dysfunction. Diagnoses have to be established from a comprehensive evaluation of the patient. A clinical examination should not rely on one view of the patient. A practitioner should have a good concept of a patient's condition from the medical and dental history. He or she should use whatever diagnostic modalities are available to verify and fortify a diagnosis. Because some "experts" believe that there is not enough sound documentation to justify the use of a modality, does not mean that documentation does not exist. Different forms of treatment have been shown to have different degrees of success. I believe that it would be counterproductive to approach treatment with one eye closed or, worse, with a closed mind. Some forms of therapy that seem outrageous today may be the cures of tomorrow. As a person pointed out to me very recently, all of the greatest scientists in the world said it was impossible for man to fly. Apparently, they just forgot to tell two bicycle makers from New Castle, Indiana.