Recognition of craniomandibular disorders.

Craniomandibular disorders often mimic diseases related to the ear, nose, and throat, so patients often seek the care of an otolaryngologist for these problems. After ruling out otolaryngologic disease, craniomandibular disorders should be considered in the differential diagnosis. If a clinical diagnosis is supported by history, symptoms, and clinical evidence, the patient should be referred in a timely manner to a dentist who is competent to manage the patient. In addition to dentists, other health care practitioners may be called on by the primary treating physician to aid in the diagnosis and treatment. These can include a neurologist, radiologist, ophthalmologist, physiatrists, physical therapist, and internist. With recent advances in imaging techniques (computed tomography and magnetic resonance imaging), precise bioelectronic measurement of mandibular movement and electromyography of masticatory function, and conservative orthotic and dental restorative treatments as well as surgical techniques including arthroscopic examination of the TMJ, craniomandibular disorders can be objectively and precisely diagnosed and treated (Figs. 10 through 16).