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Occlusal Adjustment TMD — ORE Part 1 MCQ

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ModerateOral MedicineOcclusal Adjustment TMDORE Part 1

A patient has painful temporomandibular disorder (TMD). After examination, you are considering irreversible occlusal adjustment by selective grinding as the primary treatment. Which statement best reflects the evidence-based approach?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — It is not recommended as primary treatment because evidence of benefit is insufficient

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

A is correct. Selective grinding is irreversible and evidence does not demonstrate that it provides reliable benefit as a primary treatment for TMD. A current Cochrane review found the evidence on occlusal interventions, including adjustment, insufficient to establish effectiveness; an earlier Cochrane review found no difference from control and did not recommend occlusal adjustment for TMD. B is therefore incorrect. C overstates the effect on joint noises: clicking may persist and is not predictably cured by grinding. D is incorrect because irreversible treatment should not be preferred over conservative, reversible measures. E is also wrong: neither bruxism nor jaw pain alone justifies routine irreversible alteration of tooth structure.

Reference: Singh BP, et al. Cochrane Database of Systematic Reviews. Occlusal interventions for managing temporomandibular disorders. 2024. https://pubmed.ncbi.nlm.nih.gov/12535488/