Troubles temporomandibulaires (TMD)

• Utilisez des soins culturellement adaptés qui tiennent compte des traumatismes et des violences. Expliquez pourquoi les questions sont importantes, demandez la permission avant d'aborder des sujets sensibles et adaptez la communication à la langue, à l'identité, à la culture, au handicap et aux expériences de soins de santé antérieures du patient (Agence de la santé publique du Canada, 2018).
• Informations sur le patient et le contexte : age; sex and gender when clinically relevant; language and communication needs; occupation or school; caregiving; and eating, communication, social, cultural, community, recreational or work activities important to the patient.

Principales préoccupations

• Contexte et début : gradual or sudden onset; recent or remote jaw, facial, head or neck trauma; recent prolonged dental procedure or surgery; prior episodes; jaw locking or dislocation; training, work or other load change; and whether symptoms are improving, stable, fluctuating or worsening.
• Emplacement et motif : jaw, temple, face, preauricular, ear, dental, oral or neck symptoms; side; onset, duration, course, severity, irritability and pattern over the day and night; and whether pain spreads or occurs elsewhere in the body.
• Jaw symptoms: pain or stiffness with opening, chewing, biting, yawning, talking, singing or sustained mouth opening; limited or asymmetric movement; open or closed locking; clicking, popping or crepitus; jaw fatigue; and any change in how the teeth meet.
• Symptômes associés : headache, facial sensory change, weakness, dizziness, ear pain, pressure, tinnitus, hearing change, nasal or throat symptoms, oral lesions, fever, swelling, weight change, sleep disturbance, snoring, witnessed apnoea, daytime sleepiness and other systemic or neurological symptoms.
• Impact and participation: eating and nutrition, speaking, oral hygiene, sleep, intimacy, work, school, caregiving, exercise, recreation, social contact and other valued activities.
• Revue des systèmes corporels : constitutional and infectious; neurological and headache; eyes, ears, nose and throat; oral and dental; cardiovascular and vascular; respiratory and sleep-related breathing; gastrointestinal and genitourinary; inflammatory or immune; musculoskeletal and widespread pain; endocrine or metabolic; bone health; skin; haematologic; mental health; and reproductive systems when findings may change safety, the differential diagnosis, care or referral.
• Oral, dental and jaw history: dental pain or sensitivity, decay, periodontal concerns, recent dental care, orthodontic or occlusal treatment, dentures or appliances, oral lesions, bruxism or clenching, gum chewing, nail biting and other sustained or repetitive jaw activities. Explore behaviours without assuming that any one behaviour caused the TMD.
• Santé, mode de vie et histoire : headache or migraine, inflammatory arthritis, sleep disorder, widespread pain, fibromyalgia, irritable bowel syndrome, mental-health concerns, cancer, infection and bone-health conditions; facial, jaw or cervical injury; surgery or radiation; medications and supplements, including antiresorptive drugs, anticoagulants and corticosteroids when relevant; allergies; physical activity; sleep; nutrition; smoking; alcohol; substance use; and relevant family history.
• Déterminants sociaux de la santé : work or school demands and supports, caregiving, income, housing, food security, transportation, safety, discrimination, social support and access to dental, medical, rehabilitation and mental-health care when these may shape health, care or participation (Public Health Agency of Canada, 2026a).
• Soins et interventions antérieurs : education, self-management, exercise, hands-on care, medication, dental appliance, injection, investigation, surgery or other care tried; what helped or did not help; adverse effects; and reasons care was difficult to use or continue.
• Point de vue du patient : understanding of the problem, priorities, preferences, cultural context, concerns about pain, joint sounds, bite or damage, expectations, confidence with jaw use, strengths and previous experiences of care.
• Case identification: les TMD Pain Screener ou 3Q/TMD can support history taking when TMD is suspected. A positive screen does not diagnose TMD and does not replace examination or the differential diagnosis (Beecroft et al., 2025; Schiffman et al., 2014).
• Signaler un avis : check Red Flags and refer to the separate fixed Orange Flags and Yellow Flags modules when relevant. Reassess if the symptom pattern, jaw movement, nutrition or general health changes.

Mesures des résultats

• Use a small set that reflects the patient’s goals and is practical to repeat. Record a baseline and reassess often enough to guide decisions.
• Fonctionnement propre au patient : Échelle fonctionnelle propre au patient (PSFS).
• Handicap et participation : Échelle d'évaluation du handicap de l'OMS 2.0 (WHODAS 2.0).
• Qualité de vie : WHOQOL-BREF when it fits the clinical question.
• Jaw-specific functioning: les 8-item Jaw Functional Limitation Scale (JFLS-8) when a condition-specific measure will inform care.
• Symptômes et performances : a pain rating and a small number of repeatable findings or tasks relevant to the person’s goals, such as comfortable mouth opening, chewing, eating, speaking, yawning or sleep.
• Objectifs individuels : S'entendre sur des objectifs définis par le patient et sur la manière dont les progrès seront reconnus.

Les signaux d'alerte orange indiquent qu'un problème de santé mentale ou de toxicomanie peut nécessiter une évaluation d'urgence ou rapide, voire une prise en charge partagée, et peut influencer la prise en charge musculo-squelettique. Ce n'est pas un diagnostic. En cas d'inquiétude, posez des questions directes et respectueuses en tenant compte de la sécurité immédiate, de la gravité du problème, de tout changement par rapport au fonctionnement quotidien habituel et du contexte. Les facteurs psychosociaux susceptibles d’affecter le rétablissement, mais ne nécessitant pas d’évaluation médicale ou psychiatrique distincte, sont abordés sous la rubrique « Signaux d’alerte jaune ».

ACTION : Organisez immédiatement une évaluation d'urgence en cas de danger immédiat ou de besoin médical urgent :

• Suicide, automutilation ou violence envers autrui : intention ou plan actuel, tentative récente, incapacité à rester en sécurité ou comportement suggérant un risque immédiat de préjudice grave.
• Changement grave de l'état mental : agitation extrême, confusion, désorganisation, psychose ou manie possible avec altération du jugement ou comportement dangereux, ou incapacité à satisfaire les besoins fondamentaux lorsque cela crée un danger immédiat.
• Urgence médicale ou liée à la consommation de substances : Suspicion de surdosage, intoxication grave, sevrage dangereux, délire ou autre changement soudain nécessitant des soins médicaux urgents.

En cas de danger immédiat, ne laissez pas la personne seule pendant que les secours sont organisés. Suivez les procédures d'urgence locales et composez le 911 en cas de danger immédiat ou d'urgence médicale. Si la personne a des pensées suicidaires, téléphonez ou envoyez un SMS. 9-8-8 : Ligne d’assistance en cas de crise suicidaire avec eux ou les aider à le faire.

En cas de violence, d'abus ou d'exploitation avérés ou soupçonnés, assurez immédiatement la sécurité des personnes concernées et respectez les procédures de sécurité et de signalement applicables.

ACTION : Organisez rapidement une évaluation médicale ou psychiatrique si :

• Pensées suicidaires ou d'automutilation : Des pensées sans danger immédiat.
• Symptômes ou effets importants : symptômes graves, persistants ou s'aggravant de dépression, d'anxiété, de traumatisme, de psychose ou de manie possible, de troubles alimentaires ou de consommation de substances qui affectent considérablement la vie quotidienne, la prise de décision ou la participation en toute sécurité aux soins.
• Autres motifs d’évaluation : un changement marqué par rapport au comportement ou au fonctionnement habituel ; une inquiétude concernant les effets des médicaments ou des substances ; une présentation qui dépasse les compétences du clinicien ; ou une demande d'aide.

Informer le patient des personnes à contacter, du délai de contact et de la marche à suivre en cas d'aggravation de son état. S'assurer que le patient a bien pris contact avec le service lorsque cela est cliniquement nécessaire.

ACTION : Adapter et coordonner les soins musculosquelettiques :

• Soins en toute sécurité : Les soins peuvent se poursuivre lorsqu'ils sont sécuritaires et acceptables et ne retardent pas l'évaluation nécessaire. Adaptez la communication, l'examen et les soins ; obtenir un consentement continu ; et coordonnez-vous avec les autres professionnels de la santé avec la permission du patient.
• Poursuivre l'évaluation musculosquelettique : Ne présumez pas qu'un problème de santé mentale ou de toxicomanie explique les symptômes musculo-squelettiques. Continuez à considérer les causes physiques et à tenir compte du récit du patient.
• Questionnaires: Ils peuvent soutenir la discussion et le suivi, mais ne permettent pas d’établir un diagnostic et ne remplacent ni les questions directes, ni le jugement clinique, ni les mesures à prendre.
• Soutien acceptable : Demandez à la personne quel type d’aide lui convient et si le soutien linguistique, culturel, familial, communautaire ou autre est important pour elle.

ACTION : Documentation et suivi :

Consignez la préoccupation, les questions pertinentes et les réponses de la personne, la décision relative à la sécurité et les raisons qui la justifient, les mesures prises, les conseils donnés et les références effectuées, les communications et le consentement, le suivi prévu ainsi que toute préoccupation non résolue. Respectez les exigences applicables en matière de confidentialité, de sécurité et de signalement.

Pour obtenir des renseignements sur les services provinciaux, territoriaux et nationaux, consultez : Soutien en santé mentale : obtenir de l’aide (Agence de la santé publique du Canada, 2026).

Les signaux d’alerte psychosociaux (drapeaux jaunes) sont des facteurs personnels, sociaux, professionnels, scolaires, liés aux soins de santé, environnementaux ou structurels qui peuvent influencer les symptômes, le fonctionnement, la participation aux activités ou la réponse aux soins. Ils sont liés au contexte et ne constituent ni des diagnostics ni des prédictions certaines. Ils ne signifient pas que les symptômes sont d’origine psychologique. Ils permettent d’adapter la prise en charge et ne nécessitent pas, à eux seuls, une orientation urgente vers un autre professionnel de la santé. Explorez ces facteurs par la discussion et le suivi continu des résultats, en tenant compte des priorités, des forces et de la situation de la personne. Il n’est pas nécessaire d’utiliser un score distinct pour les signaux d’alerte psychosociaux (drapeaux jaunes). Les nouveaux signes ou l’aggravation de signes d’une maladie physique grave doivent être traités selon la procédure relative aux signes d’alerte (drapeaux rouges). Les préoccupations liées à la santé mentale ou à la consommation de substances qui nécessitent une évaluation distincte, ainsi que toute préoccupation immédiate concernant la sécurité, doivent être traitées selon la procédure relative aux signaux d’alerte psychosociaux urgents (drapeaux orange) et aux protocoles d’urgence ou de protection applicables.

Explorez les facteurs pertinents :

• Compréhension, attentes et expériences en matière de soins de santé : Préoccupations liées aux blessures ou aux dommages, incertitude, attentes quant au rétablissement, confiance en ses capacités, conseils contradictoires, expériences antérieures de banalisation des symptômes ou de préjudices subis, et confiance envers les soins reçus.
• Réactions aux symptômes et à l’activité : Inquiétude, peur, évitement, alternance entre périodes d’activité excessive et périodes de repos prolongées, difficulté à gérer le rythme des activités, stratégies d’adaptation, sommeil, confiance en sa capacité à gérer ses symptômes et reprise des activités significatives.
• Emotional and life context: distress, low mood, anxiety, grief, trauma, caregiving, relationship change, job loss or other major events. Ask permission before sensitive questions and limit discussion to what is relevant and acceptable to the patient.
• Relationships, culture and strengths: supportive relationships, isolation, family and community roles, cultural or spiritual practices, identity, preferences, language and other sources of resilience.
• Work, school and administrative context: physical and psychosocial demands, control, satisfaction, job security, accommodations, return concerns, and compensation, insurance or legal processes. Explore these neutrally and in context.
• Social and structural conditions: consider social and structural determinants of health (Public Health Agency of Canada 2026), including income, housing, food security, transportation, childcare, access and cost of care, discrimination, racism, colonialism, neighbourhood and workplace conditions, and physical or digital accessibility.

ACTION: Respond with the patient:

• Ask, do not assume: use open questions to understand what helps, what gets in the way, what matters and what feels feasible. Ask about strengths and protective factors, not only difficulties. Do not treat a person’s circumstances, culture or choices as a deficit.
• Plan together: integrate relevant findings into shared goals, education, self-management, physical activity or exercise, and participation in meaningful activities. Adapt communication, setting, pace, cost and access where possible.
• Connect and coordinate: with the patient’s consent, consider appropriate clinical, social, workplace, school, community, Indigenous or culturally specific supports. Clarify who will do what and follow up when the connection is important to the plan.
• Review response to care: reassess the patient’s account and the pathway’s selected outcomes at clinically relevant points. If progress differs from expected, review the clinical impression, care plan, access and other barriers; do not automatically attribute the outcome to Yellow Flags.
• Document: record relevant factors and strengths, the patient’s priorities and preferences, agreed actions, consent, referrals or coordination, follow-up, and any change requiring the Orange Flag process.

Select examination elements that answer a clinical question or may change safety, the working presentation, care or referral. Adapt the pace, positioning and extent of examination to the patient’s symptoms, comfort, consent and abilities.

• Consent and comfort: explain the proposed head, neck, facial and intraoral examination, seek ongoing consent, use gloves for intraoral contact, and provide choices about positioning, pace, a support person or chaperone and any area the patient does not want examined.
• Observation et évaluation générale : general appearance, distress, facial symmetry, swelling, skin or oral change, jaw posture, speech, protective behaviour and opening or closing pattern. Assess vital signs when vascular, infectious or other systemic concern makes them relevant.
• Oral, dental and regional screening: inspect oral tissues and dentition within competence and scope; palpate for relevant face or neck mass, lymphadenopathy or salivary-gland change; and arrange dental or medical assessment when local pathology cannot be excluded.
• Mandibular movement: assess active opening, assisted opening when safe, protrusion and lateral excursion; note range, movement quality, deviation or deflection, end feel, familiar pain and open or closed locking. Use the same measurement method at follow-up when range will guide care (Schiffman et al., 2014; Beecroft et al., 2025).
• Temporomandibular joints and joint sounds: palpate the lateral joint region during repeated opening, closing, protrusion and lateral movement; record familiar pain, tenderness, swelling, clicking, popping or crepitus and whether joint noise is painful or limits activity. Painless noise alone does not establish a need for care (Schiffman et al., 2014; National Institute of Dental and Craniofacial Research, 2026).
• Masticatory muscles: palpate the temporalis and masseter in a standardized manner for familiar pain, local pain, spreading within the muscle or referral beyond the muscle. Routine palpation of inaccessible pterygoid regions adds limited diagnostic value (Schiffman et al., 2014; Beecroft et al., 2025).
• Neurological examination when indicated: facial movement and sensation, trigeminal sensory territories, relevant cranial nerves, limb findings, gait, balance and other neurological tests indicated by facial sensory change, weakness, dizziness, atypical pain, headache or another safety concern.
• Headache, ear and cervical assessment: assess headache features and whether familiar temporal headache is modified or reproduced by jaw use or examination; screen the ears, cervical spine, upper quarter and other relevant regions when symptoms suggest an overlapping or alternative source.
• Évaluation fonctionnelle : select safe tasks relevant to the patient’s goals, such as chewing foods of different consistency, speaking, yawning, oral hygiene or sustained mouth opening. Avoid unnecessary provocation in acute lock, dislocation, fracture or marked irritability.
• Imaging and investigations: imaging is not routine for an uncomplicated painful TMD presentation and does not replace history and examination. Coordinate imaging when fracture, tumour, inflammatory or degenerative disease, internal derangement or another diagnosis is suspected and the result is likely to change care. Cone-beam CT or CT is suited to osseous assessment; MRI is suited to the disc, joint effusion and other soft-tissue concerns (Mallya et al., 2022; Beecroft et al., 2025).
• Reassessment: repeat the findings and functional tasks needed to review progress, adverse effects, the working presentation and any change requiring dental, medical or specialist assessment.

Diagnostic framework

The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) combines Axis I physical diagnoses with Axis II assessment of pain intensity, pain-related disability, jaw limitation and psychosocial functioning. Use the current DC/TMD instruments and examination specifications when applying the framework. A screening result alone does not establish a diagnosis (Schiffman et al., 2014).

• Pain-related TMD diagnoses: myalgia, including local myalgia, myofascial pain and myofascial pain with referral; arthralgia; and headache attributed to TMD. The required history and examination reproduce familiar pain or headache in the relevant region and show that jaw movement, use or parafunction modifies the symptoms (Schiffman et al., 2014).
• Common intra-articular TMD diagnoses: disc displacement with reduction; disc displacement with reduction with intermittent locking; disc displacement without reduction with limited opening; disc displacement without reduction without limited opening; degenerative joint disease; and subluxation. History and examination support the working diagnosis, and imaging is used selectively when confirmation will change care (Schiffman et al., 2014; Mallya et al., 2022).

Working clinical presentations

Outside a specialist diagnostic assessment, describe the dominant clinical features and uncertainty rather than implying a definitive disc, joint or muscle lesion. Presentations can overlap or change (Beecroft et al., 2025; National Institute of Dental and Craniofacial Research, 2026).

• Myogenous presentation: familiar pain in the masseter or temporalis that is modified by jaw use and reproduced with relevant movement or palpation. Stiffness, fatigue, headache or cervical symptoms may coexist.
• Arthrogenous presentation: familiar pain localized to the joint region and reproduced by palpation or jaw movement. Joint sounds, movement restriction or locking may be present but are not required for arthralgia.
• Combined myogenous and arthrogenous presentation: both masticatory-muscle and joint features contribute to symptoms or activity limitation.
• Headache attributed to TMD: familiar temporal headache is modified by jaw movement, use or parafunction and is reproduced by examination of the temporalis or jaw movement. Continue to assess primary and secondary headache causes rather than assuming all headache is TMD-related.
• Mechanical joint presentation: clicking, intermittent catching, closed lock, open lock or restricted movement may suggest disc displacement or subluxation. Painless joint noise is common, and the need for imaging or referral depends on pain, locking, nutritional impact, severity and whether the result will change care.
• Alternative or overlapping presentation: dental, oral, ear, nose, throat, headache, cervical, neuralgic, inflammatory, sleep-related breathing, systemic pain or other conditions may overlap with TMD. Refer or coordinate care when needs extend beyond the clinician’s role.

Develop care with the patient using the working presentation, safety, goals, preferences, culture, access, other health conditions, previous responses and observed change. Begin with reversible options and avoid treating one structure, bite feature or habit as the required treatment target (National Institute of Dental and Craniofacial Research, 2026; Beecroft et al., 2025).

Éducation, autogestion et participation aux activités

• Explications et réassurance : options include a clear explanation of the working presentation, the generally favourable course of many TMD presentations, the meaning of painless joint sounds, and the limited relationship between pain and bite or imaging findings (National Institute of Dental and Craniofacial Research, 2026; Beecroft et al., 2025).
• Supported self-management: options include comfortable jaw movement, self-massage, heat or cold, temporary food-texture changes during a flare, awareness of clenching or repetitive jaw activity, sleep support, pacing and a written flare plan. Select only the strategies that fit the presentation and patient (Beecroft et al., 2025; National Institute of Dental and Craniofacial Research, 2026).
• Participation planning: maintain or resume eating, communication, oral hygiene, work, school, caregiving, recreation and social activities using temporary adaptations when needed. Progress toward the patient’s usual activities as comfort, movement and confidence improve.

Protection et mise en charge optimale

• Short-term load modification: reducing gum chewing, nail biting, prolonged mouth opening, very hard or chewy foods, sustained clenching or another clearly aggravating task can form part of care during an irritable period. Avoid prolonged restriction or a liquid-only diet unless medically or dentally required (Beecroft et al., 2025; National Institute of Dental and Craniofacial Research, 2026).
• Progressive jaw use: reintroduce food textures, comfortable range, speaking, yawning and other jaw tasks using symptom response, nutritional needs, activity demands and patient confidence. Acute lock, dislocation, fracture or marked nutritional restriction follows Red Flags.

Activité physique et exercices

• Jaw exercise and movement retraining: individualized coordination, relaxation, range-of-motion, stretching, endurance and graded chewing or task practice can form part of care. For persistent TMD, supervised jaw exercise and stretching are supported options. Type, amount and progression reflect the presentation, irritability, goals and response (Busse et al., 2023; Beecroft et al., 2025).
• Postural and cervical exercise: for persistent TMD, supervised postural exercise can accompany jaw-focused care when neck symptoms, movement findings or activity demands are relevant (Busse et al., 2023).
• General physical activity: maintain or gradually build physical activity that is safe, meaningful and feasible, particularly when sleep, mood, general conditioning or persistent pain affects participation.

Thérapies manuelles et interventions visant à soulager les symptômes

• Jaw mobilization and soft-tissue care: for persistent TMD, therapist-assisted jaw mobilization and manual trigger-point therapy can accompany active care when a short-term change in pain or movement helps participation. Avoid forceful techniques with acute lock, marked irritability or suspected serious pathology (Busse et al., 2023; Beecroft et al., 2025).
• Other symptom-relieving options: heat or cold, comfortable positioning and self-massage can be used when safe, acceptable and linked to a symptom or participation goal. Acupuncture is an option for persistent TMD. Review whether the option adds useful benefit (Busse et al., 2023; National Institute of Dental and Craniofacial Research, 2026).
• Culturally grounded and personal strategies: traditional, Indigenous, spiritual, community-based or other approaches identified by the patient can be included when safe, acceptable, within scope and coordinated with the patient’s chosen practitioners.

Soutien psychologique, social et interdisciplinaire

• Prise en charge tenant compte des facteurs psychologiques : supportive communication, relaxation, graded exposure and coping skills can form part of care when distress, fear, low confidence, mood or sleep affects activity. Cognitive behavioural therapy is an option for persistent TMD. Coordinate mental-health care when needs extend beyond competence or scope (Busse et al., 2023; Beecroft et al., 2025).
• Social and practical support: workplace, school, caregiving, food access, financial, transportation and care-access barriers can be addressed through practical accommodations, community resources or another appropriate professional when possible.
• Prise en charge interdisciplinaire : coordinated dental, primary-care, rehabilitation, oral medicine, neurology, headache, sleep, mental-health, dietetic or pain care can fit persistent disabling symptoms, comorbidity, nutritional restriction or diagnostic needs that one clinician cannot address.

Dental, medication and procedural shared care

• Révision de la médication : review current use, intended benefit, adverse effects, interactions and relevant gastrointestinal, renal, cardiovascular, bleeding, sedation or dependence risk with an authorized prescriber or pharmacist. Evidence for medication in TMD is limited, and selection, prescribing and dosing remain with that provider. NSAIDs combined with opioids do not form part of care for chronic TMD pain (National Institute of Dental and Craniofacial Research, 2026; Busse et al., 2023).
• Reversible occlusal appliance: dentist-led shared decision-making about a full-coverage appliance can fit selected cases, but routine appliance use for chronic TMD pain is not supported. It is not stand-alone care, and fit, symptoms, tolerance and bite require monitoring. Stop use and arrange dental review if pain or bite changes worsen (Beecroft et al., 2025; Busse et al., 2023; Royal College of Dental Surgeons of Ontario, 2019).
• Irreversible or invasive procedures: routine conservative care does not include grinding teeth, crowns or orthodontic procedures intended to permanently change the bite, irreversible splints, discectomy, botulinum toxin, trigger-point or intra-articular injections, arthrocentesis or surgery. Arthrocentesis or another procedure can be assessed by an oral and maxillofacial specialist for selected severe closed-lock or structural presentations. Referral does not imply that a procedure is appropriate, and an informed second opinion can help clarify benefits, harms and alternatives (National Institute of Dental and Craniofacial Research, 2026; Busse et al., 2023; Beecroft et al., 2025).

Suivi et réévaluation

• Agree on a reassessment point based on the presentation, safety, goals, care being tried, nutritional impact, patient needs and access rather than a fixed visit schedule.
• Repeat the small outcome set recorded at baseline and review symptoms, jaw movement, eating and speaking, sleep, relevant neurological or oral findings, functioning, participation, benefits, adverse effects, treatment burden and progress toward patient-defined goals.
• Continue what is useful and acceptable; adapt or stop what is not; and revisit Red Flags, the working presentation, dental or medical differential, imaging, referral or shared care when progress differs from expectations or new safety concerns emerge.

• Évolution attendue : many TMD presentations improve or become manageable with time and conservative care, while some persist or recur. Joint sounds and disc or degenerative findings often remain stable and do not determine pain or activity. Use the person’s observed course rather than a promised timeline (National Institute of Dental and Craniofacial Research, 2026; Beecroft et al., 2025).
• Facteurs associés à une évolution moins favorable : greater pain and interference, longer symptom duration, widespread pain, fibromyalgia, headache, sleep disturbance, anxiety, depression, post-traumatic stress, social stress and difficulty accessing coordinated care may be associated with persistent painful TMD. These factors do not prove cause or determine an individual’s outcome (Beecroft et al., 2025).
• Facteurs pouvant favoriser le rétablissement : a clear working diagnosis, confidence with safe jaw use, feasible self-management and exercise, supportive relationships, adequate nutrition and sleep, practical accommodations and access to coordinated dental, medical and rehabilitation care may support recovery (Beecroft et al., 2025).
• Discussion du pronostic : validate the person’s experience, describe uncertainty in plain language, ask what they want to know, and update the outlook using repeated outcomes and observed change. Do not treat an imaging finding, bite feature, behaviour or screening score as a fixed prediction.