TMD Introductory Course

This 5-hour interactive, self-paced online course is designed to improve temporomandibular disorders (TMD) care by increasing knowledge and competence. This curriculum maximizes learner engagement and retention through thoughtfully designed multimedia content.

Earn 5.0 CE Credits

Video introduction to this course

Key Features:

  • TED-Style Videos: Dynamic and concise presentations introduce key concepts in TMD care. 
  • Interactive Case-Based Scenarios: Realistic patient cases with built-in feedback provide hands-on learning to reinforce comprehension. 
  • Clinical Tools: Resources for TMD assessment and patient education, enabling immediate application in clinical settings.
  • Asynchronous Delivery: Learners can progress at their own pace, ensuring accessibility for diverse audiences.
  • Audience Suitability: Ideal for both students and professionals seeking continuing education. 

Course Structure:

The program is divided into four modules: 

  • TMD Pathophysiology
  • Screening and Assessment
  • Diagnosis
  • Management

This course empowers learners with the knowledge and tools necessary to elevate TMD care while fostering collaboration across healthcare disciplines. 

Learning Objectives:

  1. To understand the basic mechanisms behind TMD.

  2. To learn tools and techniques for effective patient evaluation.

  3. To build competence in identifying common TMD types and comorbidities.

  4. To develop skills to create effective treatment plans.

Module 1 – TMD Pathophysiology

1-1 TMD Prevalence and Impact

Commander James Hawkins (USN) – Dr. Hawkins serves as the Department Chair of the Orofacial Pain Center at the Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, in Bethesda, MD. He is a Diplomate of the American Board of Orofacial Pain and a fellow of the American Academy of Orofacial Pain.

1-2 Masticatory Anatomy

Lieutenant Colonel Paul Goforth (USA) – Dr. Goforth is a board-certified Endodontist and is currently pursuing Orofacial Pain specialty training at Navy Postgraduate Dental School, Naval Medical Leader and Professional Development Command.

1-3 TMD Physiology

Commander James Hawkins (USN)

1-4 Comorbidities and Risk Factors

Commander James Hawkins (USN)

Module 2 – TMD Assessment

2-1 TMD Screening

Commander James Hawkins (USN)

2-2 TMD History

Lieutenant Colonel Thomas Weber (USAF) – Dr. Weber serves as Director of Orofacial Pain at Joint Base San Antonio-Lackland, TX. He received his certificate in Orofacial Pain from the University of Kentucky College of Dentistry in 2014. Dr. Weber is a Diplomate of the American Board of Orofacial Pain and a fellow of the American Academy of Orofacial Pain.

2-3 TMD Examination

Commander James Hawkins (USN)

2-4 TMD Diagnostic Testing and Imaging

Captain Istvan (Steve) Hargitai (USN) – Dr. Hargitai serves as Professor and Staff at the Orofacial Pain and Oral Medicine departments at the Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, in Bethesda, MD.  Dr. Hargitai is a Diplomate of the American Board of Oral Medicine and the American Board of Orofacial Pain.

Auriculotemporal Nerve Block
This video will demonstrate how to perform auriculotemporal nerve block.

Clinical Tools Overview
The contents in this video describe the documents in the resource tab.

Module 3 – TMD Screening

3-1 Myogenous TMD

Commander James Hawkins (USN)

3-2 Arthrogenous TMD

Commander James Hawkins (USN)

3-3 Mimickers

Commander Preston Criddle (USN) – Dr. Criddle serves as the Orofacial Pain Residency Program Director at the Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, in Bethesda, MD. He is a Diplomate of the American Board of Orofacial Pain and a fellow of the American Academy of Orofacial Pain.

Module 4 – TMD Management

4-1 Management Strategies

Commander James Hawkins (USN)

4-2 TMD Self Care

Commander James Hawkins (USN)

4-3 TMD Pharmacology

Commander Abby Schmidt (USNR) – Dr. Schmidt served on Active Duty in the United States Navy for 11 years. During that time, she completed an Orofacial Pain residency at the Naval Postgraduate Dental School in 2018. In 2022, she moved back to her home state of Michigan and began private practice at the Michigan Center for Facial pain and Sleep in the metropolitan Detroit area. Dr. Schmidt is a Diplomate of the American Board of Orofacial Pain and a fellow of the American Academy of Orofacial Pain.

4-4 Referrals

Commander James Hawkins (USN)

TMD Self Care Video

Downloadable Resources

Module 1

Resources.pdf

 

Module 2

Resources.pdf
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TMD Comprehensive History (Patient Completes).pdf
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TMD Essentials Clinician Evaluation Form.pdf
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TMD Examination Form (Clinician Completes).pdf

 

Module 3

Resources.pdf
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Patient Education Graphics and Animations.pptx

 

Module 4

Resources.pdf
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TMD Infographic.pdf
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TMD Poster - Handout.pdf

 

Other

Imaging Credits

 

Please complete the “AAOP Intro Course Quiz” to earn your credits

TMD Introductory Course

1 / 22

A 32-year-old man comes to your office with a 2-year history of his mouth getting stuck open twice per month when yawning, after which is able to maneuver his mandible to close his mouth within seconds. These episodes are associated with a focal right preauricular pain that lasts for 30 seconds. On examination, his is mouth opening is 60mm. Which muscle assists in opening the mandible?

2 / 22

The intermittent pain the patient experiences is associated with the temporomandibular joint.  Which nerve provides >75% sensory innervation to the TMJ?

3 / 22

A 40-year-old female comes to the office with a 1-year history of right maxillary sinus and maxillary tooth pain.  The pain is worse upon opening, chewing, and clenching the teeth together.  On examination, palpation of the right anterior temporalis replicated the patient’s maxillary sinus and tooth pains.  What is the most likely mechanism of this effect?

4 / 22

A 65-year-old man presents to the office with symptoms indicating a myocardial infarction, including chest pain, left arm pain, heartburn, and shortness of breath.The patient also reports left jaw and tooth pain.

Which nerve is responsible for these facial pain symptoms?

5 / 22

A 52-year-old female comes to the office with a 25-year history of bilateral facial pain. The pain is a constant dull ache with an average pain intensity of 5/10. Upon examination, the patient is tender to palpation of the bilateral masseter & temporalis muscles. Which of the following comorbid conditions is this patient most likely to have?

6 / 22

A 25-year-old female comes to your office for evaluation of her temporomandibular disorder.  The patient states she has a history of asthma, menstrual migraine, seasonal allergies, insomnia, and urinary tract infections preceding the onset of the TMD.  Which of the following factors in the patient’s history most increased her risk for developing this condition?   

7 / 22

A 55-year-old man comes to the office with a 2-year history of bilateral masseter and temporalis myalgia that occurs daily on awakening.  The pain lasts approximately 1 hour.  The patient also reports daytime tiredness and snoring.  Which of the following additional information regarding this patient’s history is most appropriate to obtain at this time?

8 / 22

A 29-year-old man comes to the office with a 3-month history of limited mouth opening.  On examination, the patient can open to a maximum of 25mm.  Which of the following is the most appropriate focus of the physical examination at this time to help determine if the limited mouth opening is due to an anteriorly displaced disc without reduction?

9 / 22

A 25-year-old woman comes into the office with a 4-month history of focal unilateral TMJ area pain.  The pain is not provoked with mandibular movement, and there are no positive palpation findings on examination.  Which of the following is the most appropriate diagnostic test to perform at this time to help determine if the pain originates from the TMJ?

10 / 22

A 30-year-old man comes into the office with a 4-month history of focal TMJ area pain and a grating noise on mouth opening.  The patient states that both the pain and noise are progressively worsening.  Which is the most appropriate diagnostic image to obtain at this time to view the bony structures of the TMJ?

11 / 22

A 29-year-old man comes to the office with a 3-month history of right sided pre-auricular clicking.  The click is painless and not impacting the patient’s quality of life.  On examination, the click occurs at 25mm of mouth opening, 5mm of mouth closing, and with left lateral jaw excursion.  During opening the mandible deviates to the right with correction to center.  Which of the following is the most likely diagnosis?

12 / 22

A 45-year-old woman comes to the office with a 6-month history of right sided jaw pain, maxillary tooth pain, and retro orbital headache.  On examination, the patient opens to a maximum of 40mm with mild aggravation of the chief complaints.  Excursive movements are normal and non-painful.  Intraoral palpation of the right mandibular ascending ramus to the coronoid process replicates the patient’s pain complaints.  Which of the following is the most likely diagnosis?

13 / 22

A 35-year-old man awoke 3 days ago with limited mouth opening.  The patient reported a history of bilateral TMJ clicking that also stopped 3 days ago.  On examination, the patient opens to a maximum of 25mm with a hard end-feel.  During opening the mandible deviates to the right without correction to center.  Mandibular excursion is 8mm to the right and 3mm to the left.  Which of the following is the most likely diagnosis?

14 / 22

A 40-year-old woman comes to the office with a 2-year history of right sided TMJ, maxillary sinus, and ear pain.  On examination, these pains are replicated with wide mouth opening, as well as mandibular protrusion and left lateral excursive movements against resistance. Which of the following is the most likely diagnosis?

15 / 22

A 25-year-old woman comes to the office with 12-year history of right sided jaw pain that occurs 10 days per month.  The patient has no pain today.  When present, the pain is accompanied by nausea and sensitivity to bright lights.  On examination, the patient is able to open to 50mm pain free.  All palpation findings were non-painful.  What is the most appropriate differential diagnosis?

16 / 22

A 60-year-old man comes to the office with a 2-day history of left-sided jaw and neck pain.  The pain is pressing and averages a 4/10 intensity.  The pain worsens when walking upstairs.  The patient’s health history includes hypertension and hyperlipidemia.  On examination, the patient is able to open to 50mm pain-free.  All palpation findings were non-painful.  What is the most appropriate differential diagnosis?

17 / 22

A 45-year-old woman comes to the office with a 4-year history of bilateral jaw pain. The pain is a constant ache with an average intensity of 4/10. The patient’s health history includes diagnoses of fibromyalgia and depression.On examination, the patient opens to a maximum of 40mm with mild aggravation of the chief complaint. All masticatory and cervical palpation sites were tender. Which of the following is the most appropriate initial step in this patient’s care?

18 / 22

A 32-year-old man comes to the office with a 5-year history of bilateral masseter pain.  The pain is a constant ache with an average intensity of 4/10.  The patient also notes a 5-year history of stable mild anxiety.  The patient also notes clenching the teeth together, keeping the tongue pressed to the palate, and chewing gum regularly.  On examination, palpation of the bilateral masseters replicated the primary pain complaint.  You have educated the patient on the diagnosis of masticatory myalgia.  Which of the following is the most appropriate next step in patient care?

19 / 22

A 38-year-old woman comes to the office with a 20+-year history of bilateral jaw, temple, and neck area pain.  The pain is a constant ache with an average intensity of 4/10.   The patient’s health history includes anxiety, widespread body pain, chronic headache, and poor sleep quality.  She has not been evaluated by a health professional for any of these concerns. On examination, the patient opens to a maximum of 30mm with mild aggravation of the chief complaint.  All masticatory and cervical palpation sites were tender.  Which of the following is the most appropriate step in this patient’s care?

20 / 22

The previous patient would like to utilize a medication as part of her pain management plan.  The patient is not currently using any medications and has no known drug allergies.  She has no known health conditions that would preclude use of any pharmacologic agent.  She has had tubal ligation surgery to prevent pregnancy.  Which of the following is the most appropriate pharmacotherapy?

21 / 22

Evaluation - How confident do you feel in applying the subject matter discussed in your practice?

22 / 22

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Materials in this course are derived from MedEdPORTAL at https://www.mededportal.org/doi/10.15766/mep_2374-8265.11467 The site notes the following: Copyright & Permissions: US Government work in the public domain. This is an open-access publication distributed under the terms of the Creative Commons Public Domain Mark. Disclaimer: The views in this article reflect the results of research conducted by the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, Uniformed Services University of the Health Sciences, or the US Government. We are military service members or federal/contracted employees of the US government. This work was prepared as part of our official duties. Title 17 U.S.C. 105 provides that “copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a US Government work as work prepared by a military service member or employee of the US Government as part of that person’s official duties. Neither we nor any member of our families have a financial arrangement or affiliation with any corporate organization offering financial support or grant monies for this research, nor do we have a financial interest in any commercial product(s) or service(s) we will discuss in the presentation or publication.

  American Academy of Orofacial Pain is an ADA CERP Recognized Provider.  ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.