César Fernández-de-las-Peñas and Juan Mesa-Jiménez. 2018; Handspring Publishing price £39.50 pp. 350 ISBN:

9781909141803

This 350-page book, also available as an e-book, gives a comprehensive account of temporomandibular disorders (TMD), from the history and examination to the conservative management. It has a strong evidence-based approach, as seen in the extensive reference sections, and is combined with clinical opinions from specialists in epidemiology, physical therapy, orofacial pain, orthodontics, maxillo-facial surgery and rehabilitative medicine. It is aimed at specialist practitioners in TMD.

The book has four parts. The first of these is an introduction to TMD. The initial chapters cover definitions, epidemiology, aetiology, classifications, and pathophysiology. Although these topics are well covered, I believe, they go into too much detail by critiquing individual studies. Tables and graphs are used sparingly to illustrate the points made. The classification chapter is better and breaks up TMD into measurements for pathology and their effects on patients. Chapters on pathophysiology and referred pain flow well with good diagrams and clinical applications.

The second part discusses the examination of TMDs. The chapters on history and examination of the patient have a nice order, are well-detailed and have useful proformas for practice.

The third part explores manual therapy which includes joint mobilisation, manipulation interventions for the cervical spine and temporomandibular joint, therapy for myofascial trigger points, clinical classification of cranial neuropathies and postural and motor controls. The first of these chapters is purely a systematic review of the evidence of these treatments, whereas the others give a background and then great clinical photos and instructions on how to do the interventions.

The final part covers 'other' interventions and again follows the pattern of giving an account of the science behind them and then useful photos and instructions for dry needling, acupuncture, treating the brain through motor control and psycho-emotional changes and pain psychology. Like part three, it is more case-based.

In summary, this comprehensive text often reads more like a systemic review of the evidence than a textbook and lacks clear clinical guidance for when to use each intervention. However, the clinical chapters on assessment and the interventions are well put together and would be helpful for a specialist in TMD. I believe it would be of little benefit to a dental student, general dentist or dental core trainee, however, it would have a place in a dental school library.