The first thing to determine what type of TMD exists is to fully do a proper diagnostic analysis. First you need to load the joint in centric to determine if pain is originating from the intracapsular area. Second you need to palpate all muscles associated with the joint along with mastication. Most TMJ issues [80%] are caused by malocclusion. If there is a click, then one must find out if is a Medial pole or Lateral pole click and the severity. You can also us a “doppler” to listen to joint sounds to determine this. This means that a simple equilibration may correct the problem, and an appliance may not be needed. For patients that have parafunction issues, a flat plane occlusal splint is idea with equal intensity contacts. If there is joint damage, then MRI is recommended for further diagnosing.
