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TMJ disorders management and referral pathway for Leeds Dental Institute (May 2012) General Dental Practitioner assessment Painless click Muscle tenderness Closed lock <2cm Painless joint crepitations Tenderness over joint Joint crepitations with pain Explanation, reassurance and discharge Increased resistance to movement Conservative management - Explanation and reassurance Interim conservative advice - Soft diet - NSAIDs - Soft bite raising appliance if indicated (e.g. parafunction) Review in 6 weeks or sooner if symptoms increase Improvement? Yes Review at regular intervals as required No Referral to Oral Maxillofacial Department via referral form