The Temporomandibular Syndrome

Howard D. Sutcher, DDS; Martin D. Lerman, DDS
JAMA. 1973;225(10):1248-1249. doi:10.1001/jama.1973.03220380060024.
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To the Editor.—  In his editorial (224:622, 1973) Greene called attention to the problems of the many patients who suffer with the temporomandibular joint pain-dysfunction syndrome (TMJ-PDS). He proposed a "clinical system" of diagnosis and treatment in which the central modalities are proper explanation, medications, rest, and heat.Dr. Greene referred to an extensive literature and cited his own recent survey of professional attitudes about the TMJ-PDS,1 both of which indicate that his proposed "system" has been widely employed for many years by physicians and dentists. We agree that, initially, a conservative approach is always the method of choice. However, in the editorial, Dr. Greene did not include the results of his own studies which showed that these modalities are beneficial in only about 60% of TMJ patients and infrequently effect a complete remission of symptoms.2-4 He appears to have ignored the 40% of his patients who were


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