Date amended:
Statements of Principles
Current RMA Instruments

Reasonable Hypothesis SOP

47 of 2018 as amended

Balance of Probabilities SOP

48 of 2018 as amended

Changes from previous Instruments



ICD Coding
  • ICD-9-CM Code: 524.60
  • ICD-10-AM Code: M26.60
Brief description

Temporomandibular disorders are a complex group of disorders involving the temporomandibular joint (of the jaw) and related structures and manifesting principally as types of pain disorder.  There is typically a structural component to the disorder but subjective and psychological factors generally also play a role.

Confirming the diagnosis

Diagnosis is based on the history and clinical findings and should be made by a clinician with relevant expertise in temporomandibular joint (TMJ) disorders (see below).  Imaging evidence may be useful but is not essential. The SOP definition requires clinically significant pain related to jaw movement and associated distress or functional impairment due to jaw symptoms.

The relevant medical/dental specialist may be an ENT surgeon, an oral/maxillary surgeon, a prosthodontist or another dentist specialising in TMJ disorders.

Additional diagnoses that are covered by SOP
  • Temporomandibular joint dysfunction
Conditions that are excluded from SOP
  • Headache disorders*
  • Orofacial pain of dental origin

* another SOP applies

Clinical onset

The condition is characterised by acute or chronic musculoskeletal pain triggered by jaw motion, dysfunction of the masticatory system, TMJ tenderness, and neck stiffness and pain.

Time of clinical onset will generally be based on onset of pain.  The pain of temporomandibular disorder is typically unilateral facial pain, related to jaw movement and usually described as a dull ache that waxes and wanes in intensity. The pain can radiate to the ear, temporal and periorbital regions, the angle of the jaw, and, frequently, the posterior neck. The pain may be daily or intermittent.  Other presenting features may include headache and jaw dysfunction.

Clinical worsening

Treatment is generally effective in controlling or improving symptoms in most people. Clinical worsening may be evidenced by the development of more severe, persistent symptoms.