LETTERS alternative. While 15% of GDPs referred their patients with TMJ problems immediately, 40% referred their patients after 3-6 months, presumably after a period of conservative management which is in line with that which most TMJ surgeons feel is appropriate. The majority of dentists were unclear about the surgical interventions for TMJ dysfunction with nearly half unaware that TMJ replacement existed. Over 90% of GDPs thought that they would benefit from a refresher course. Patients with TMJ problems, often presenting with varied complaints, are encountered by dental practitioners on a daily basis. It is important to have a sound knowledge and understanding to formulate a treatment plan or to refer when appropriate. These results highlight that TMJ examination, knowledge and pathology is not well understood and they suggest that more training in TMJ pathology at an undergraduate level and during vocational training is warranted. K. Kassam Senior Oral & Maxillofacial Specialist Trainee
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