Sir, we have recently conducted a survey on the current status of knowledge of TMJ amongst UK GDPs which illustrates that basic history taking of temporomandibular joint dysfunction is not well understood.

An online survey tool was emailed to 150 newly qualified GDPs to which 142 responded. The survey contained the following questions:

  1. 1

    Are you comfortable taking TMJ history?

  2. 2

    Do you know the pre-existing factors that are relevant to TMJ pathology?

  3. 3

    Are you comfortable in examination of TMJ?

  4. 4

    Do you make splints for your TMJ patients?

  5. 5

    What type of splint do you make for your patient if one is fabricated?

  6. 6

    Do you prescribe jaw exercises for your patients?

  7. 7

    How long do you treat a patient conservatively prior to referring to secondary care?

  8. 8

    Have you heard of Wilkes Clinical Score of staging for TMJ pathology?

  9. 9

    Do you know about the following surgical treatments for TMJ? Highlight Arthroscopic Lysis and Lavage, meniscopexy, eminectomy, discectomy, condylar shave, TMJ replacement (Fig. 1)

    Figure 1
    figure 1

    Do you know about the following surgical treatments for TMJ?

    Full size image
  10. 10

    Do you think you would benefit from additional/refresher TMJ teaching?

Almost half (46.8%) the respondents were not comfortable with taking a TMJ history and over half (56.6%) were not entirely comfortable with examination of the TMJ. There was varied fabrication of different types of splints to treat TMJ symptoms. A recent Cochrane analysis1 again showed that no one bite splint is superior to others which suggests that more time-consuming repositioning or stabilisation splints should not be used in the first instance, with the simple lower soft splint providing a good alternative. While 15% of GDPs referred their patients with TMJ problems immediately, 40% referred their patients after 3-6 months, presumably after a period of conservative management which is in line with that which most TMJ surgeons feel is appropriate. The majority of dentists were unclear about the surgical interventions for TMJ dysfunction with nearly half unaware that TMJ replacement existed. Over 90% of GDPs thought that they would benefit from a refresher course.

Patients with TMJ problems, often presenting with varied complaints, are encountered by dental practitioners on a daily basis. It is important to have a sound knowledge and understanding to formulate a treatment plan or to refer when appropriate. These results highlight that TMJ examination, knowledge and pathology is not well understood and they suggest that more training in TMJ pathology at an undergraduate level and during vocational training is warranted.