October 18, 1976

"The Great Imposter"-Reply

Author Affiliations

The Temporomandibular Joint Research Foundation La Crescenta, Calif

JAMA. 1976;236(16):1846. doi:10.1001/jama.1976.03270170012012

"Diseases of the Temporomandibular Joint" is, I believe, an appropriate title, with the substitution of the word "apparatus" for the word "joint." This then, can include the joint, muscles, teeth, bony anatomy, structures of the middle and inner ear, and psyche.

Anxiety is but one factor causing clenching and grinding of the teeth (bruxism). Dental malocclusion, skeletal malrelationships, and physical injury to the joint are other causes of this habit.

Although not well understood in the past, arthritis and other organic diseases of the joint are most common. This has been substantiated by such experts as Thoma,1 Carlsson et al,2 Schwartz,3 Mayne and Hatch,4 and others.5

Surgery for the myofascial paindysfunction syndrome is usually not necessary. However, reconstructive surgeries for organic diseases of the temporomandibular apparatus are most appropriate and will increase in the future. "The Great Imposter" is more than referred pain