Temporomandibular Joint Disorder (TMJ)
Adult

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Emergency Referrals

Useful Management Information

Assessment and management information may be found on a range of conditions at HealthPathways
Mouth opening measurement is a simple and valuable assessment that involves using a ruler to measure the distance between the upper and lower front teeth at maximum mouth opening. This measurement provides critical information about the severity of the patient’s condition and helps guide appropriate triaging and management.
Where appropriate and available, non-urgent referrals may be sent to public Physiotherapy-led Screening Clinics for initial assessment and management. A surgical assessment may then be arranged or ruled out.
Consider referral to dentist if there is poor dental health, suspected malocclusion or dental pathology, or for consideration of an occlusal splint
Consider referral to Psychology services for Cognitive Behavioural Therapy (CBT), if there is marked psychological distress or to help with pain-related anxiety
Consider referral to Physiotherapy for advice on passive jaw stretching exercises, posture training, and massage, or acupuncture to help relax muscle spasm

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Acute TMJ injuries Acute unexplained limitation of mouth opening, with or without associated pain
Category 2 (appointment within 90 calendar days)	Recurrent dislocation
Category 3 (appointment within 365 calendar days)	Chronic TMD symptoms persisting for more than three months despite appropriate primary care management or community-based non-surgical care, including behavioural strategies, physiotherapy, dental care and/or psychology care Uncertain diagnosis requiring Maxillofacial assessment Marked psychological distress associated with symptoms and/or occlusal preoccupation (persistent hyper-awareness or hypervigilance of their bite) Chronic TMJ dysfunction (osteoarthropathies) Ongoing pain without clear cause, including chronic or widespread discomfort
If your patient does not meet the minimum referral criteria Assessment and management information may be found on a range of conditions at HealthPathways If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

•
Any obvious known arthropathy
•
Plain imaging of OPG open and closed views
•
Mouth opening measures* between the teeth (cm/fingers) including whether patient has:
- Pain
  lateral condyle TMJ
- Masseter
  pain/tenderness
- Temporalis
  pain/tenderness
- Headaches
- Neck
  pain
- Shoulder
  pain
- Any
  other history of arthropathy of other joints
- History
  of autoimmune disorders with joint involvement
- Previous
  trauma joints
- Previous
  surgery on TMJ trauma/surgery
- Ear
  examination
- Previous
  history of facial pain syndromes

* Mouth opening measurement: Use a ruler to measure the distance (in centimetres or fingers) between the upper and lower front teeth at maximum mouth opening.

Additional Referral Information

CT face results

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Medical Objects Account: GQ42150009Z

HealthLink EDI: Qldgchsd

Internal Referrals

Oral and Maxillofacial Surgery qhRefer

Fax

(07) 5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Michael Hurrell

Facilities

Gold Coast University Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Temporomandibular Joint Disorder (TMJ)Adult