Much attention in the literature has been focused on the relationship between TMD and orthodontic treatment. Whilst TMD is common in the orthodontic aged population whether orthodontic treatment is carried out or not, there is no evidence to support the theory that orthodontic treatment causes TMD or cures it.29 Pre-existence of TMD should be recorded, and the patient advised that treatment will not predictably improve their condition. Some patients may suffer with increased symptoms during treatment which must also be discussed at the beginning of treatment. Where patients experience symptoms during treatment, treatment should be directed at eliminating occlusal disharmony and joint noises whilst reassuring the patient. Standard
treatment regimes may also be indicated eg soft diet, jaw exercises. We have not reviewed this area in detail in this section as it is dealt with under facts and fantasy in the next, but an excellent overview of the relation between orthodontics and occlusal relation has recently been published.30
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