Simmons H Clifton
Oral and Maxillofacial Surgery Department at Vanderbilt University School of Medicine.
Cranio. 2012 Jan;30(1):9-24. doi: 10.1179/crn.2012.003.
Dr. Charles Greene's article, "Managing the Care of Patients with TMDs A New Guideline for Care," and the American Association for Dental Research's (AADR) 2010 Policy Statement on Temporomandibular Disorders, published in the Journal of the American Dental Association (JADA) September 2010, are reviewed in detail. The concept that all temporomandibular disorders (TMDs) should be lumped into one policy statement for care is inappropriate. TMDs are a collection of disorders that are treated differently, and the concept that TMDs must only be managed within a biopsychosocial model of care is inappropriate. TMDs are usually a musculoskeletal orthopedic disorder, as defined by the AADR. TMD orthopedic care that is peer-reviewed and evidence-based is available and appropriate for some TMDs. Organized dentistry, including the American Dental Association, and mainstream texts on TMDs, support the use of orthopedics in the treatment of some TMDs. TMDs are not psychological or social disorders. Informed consent requires that alternative care is discussed with patients. Standard of care is a legal concept that is usually decided by a court of law and not decided by a policy statement, position paper, guidelines or parameters of care handed down by professional organizations. The 2010 AADR Policy Statement on TMD is not the standard of care in the United States. Whether a patient needs care for a TMD is not decided by a diagnostic test, but by whether the patient has significant pain, dysfunction and/or a negative change in quality of life from a TMD and they want care. Some TMDs need timely invasive and irreversible care.
查尔斯·格林博士的文章《颞下颌关节紊乱病患者的护理管理:一项新的护理指南》以及美国牙科研究协会(AADR)于2010年9月发表在《美国牙科协会杂志》(JADA)上的关于颞下颌关节紊乱病的政策声明,将得到详细审查。将所有颞下颌关节紊乱病(TMDs)归为一项护理政策声明的概念是不合适的。TMDs是一组需要不同治疗方法的疾病,而认为TMDs必须仅在生物心理社会护理模式下进行管理的概念也是不合适的。根据AADR的定义,TMDs通常是一种肌肉骨骼骨科疾病。经过同行评审且基于证据的TMD骨科护理是可用的,并且适用于某些TMDs。包括美国牙科协会在内的有组织的牙科行业以及关于TMDs的主流文献,都支持在某些TMDs的治疗中使用骨科方法。TMDs不是心理或社会疾病。知情同意要求与患者讨论替代护理方法。护理标准是一个法律概念,通常由法院决定,而不是由专业组织发布的政策声明、立场文件、指南或护理参数决定。2010年AADR关于TMD的政策声明不是美国的护理标准。患者是否需要TMD护理不是由诊断测试决定的,而是由患者是否因TMD而出现严重疼痛、功能障碍和/或生活质量的负面变化以及他们是否需要护理决定的。一些TMDs需要及时的侵入性和不可逆的护理。