How should I manage a patient with suspected temporomandibular joint dysfunction before considering referral to maxillofacial surgery?

Initial management of suspected temporomandibular joint dysfunction (TMD) in primary care should focus on conservative, non-invasive approaches before considering referral to maxillofacial surgery. This includes patient education about the condition, reassurance, and advice on self-care measures such as avoiding excessive jaw movements, eating soft foods, and applying warm compresses to reduce pain and muscle spasm ¹.

Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain and inflammation. Additionally, simple jaw exercises to improve mobility and reduce muscle tension may be recommended ¹.

Referral to specialist services, including maxillofacial surgery, should be considered only if symptoms persist despite conservative management, if there is significant functional impairment, or if there are red flags such as severe pain, joint locking, or suspicion of other pathology ¹.

Multidisciplinary approaches involving dental specialists, physiotherapists, and pain management teams have been shown to be effective in managing TMD, emphasizing the importance of a holistic approach before surgical options are explored (Lobbezoo et al., 2000).

Furthermore, telemedicine has emerged as a useful adjunct in the management of TMD, allowing for remote assessment and guidance on conservative treatments, which may improve access and adherence to therapy (Salazar-Fernandez et al., 2012).