Screening orthodontic patients for temporomandibular disorders

At a minimum, a screening evaluation for TMDs should be included as a component of the initial orthodontic evaluation process. It is also important for orthodontists to discriminate between major (significant) and minor (insignificant) signs and symptoms of TMD if they are discovered during the screening. If the patient has significant TMD issues, the orthodontist must decide whether to take on the responsibility for managing them prior to initiating orthodontic treatment. If not, an appropriate referral must be made. Furthermore, orthodontists must respond appropriately when a patient is referred specifically for the treatment of TMD issues. In this circumstance, it is important that communication with both the patient and the referring dentist follow current scientific concepts about TMD–orthodontic relationships. If TMD signs and symptoms arise during orthodontic treatment, orthodontists must be cognizant of proper procedures. Because there is some potential for the development of TMD issues after orthodontic treatment in a segment of their population, it is important for orthodontists to react appropriately in these circumstances.