Dr. Guinn’s Lecture Syllabus

Cutting Through the Confusion About TMD


A Syllabus for Dentists and other Health Care Professionals regarding the diagnosis and management of Temporomandibular Disorders and Orofacial Pain

James L. Guinn, D.M.D.

Salt Lake City, UT

Revised 5/2011


There may be no other condition as misunderstood, misdiagnosed, and mistreated as jaw disorders and associated pain.

As a clinician, this syllabus may make you uncomfortable.  Frankly, it is my opinion that we should all be uncomfortable regarding this topic, because as a profession we have a less than stellar track record in managing it.  However, it is not my purpose to criticize any one individual or group.  Reasonable people can certainly disagree, especially on this topic.

In the five web pages below, the following topics are discussed:

  • A brief history of how jaw problems have been managed
  • The many challenges associated with understanding the etiology of jaw disorders
  • The reasons for the conflicting philosophies in the TMD field
  • The ethical lapses among some treating clinicians today
  • Dr. Guinn’s 35-year journey though the labyrinth called TMD
  • Guidelines for how to diagnose and treat this patient population
  • The challenges of conducting sound scientific research in this field

The purposes of this syllabus:

  • Dispel the myths and misconceptions surrounding TMD.
  • Provide the clinician with a sound foundation for evaluating the many divergent opinions expressed by so-called experts in the field.
  • Speak for those who cannot speak for themselves.  Our patients can go to 5 dentists and get 5 highly conflicting opinions about the cause of their jaw symptoms and the treatment required.  They deserve better than this.

What this Syllabus is Not:

This is not a typical TMD presentation.  It does not include a review of anatomy, physiology, patho-physiology, etiology, occlusion, jaw orthopedics, imaging, diagnostics, or specific treatment modalities.

Disclaimer:  I have no financial interest in any product, book, program, philosophy, drug, treatment modality, professional organization, or other resource, which may be discussed or mentioned in this paper.

© James L. Guinn, D.M.D., 2009, 2011

Chapter 1  Confronting the Confusion

Chapter 2  Where Do We Go From Here?

Chapter 3  Patient Management

Chapter 4  Frequently Asked Questions

Appendix  Equivocal Results in TMD Research