TABLE 1.

Situations when it is recommended that dental practitioners consider referring TMD patients to a physical therapist.

Mechanism	Situation
Cervical	The patient has neck pain worthy of treatment.
	The patient has cervicogenic headaches (headaches that can be reproduced by palpating the neck).
Postural	The patient has moderate to severe forward head posture; a study suggests these patients may obtain significant TMD symptom improvement from posture exercises in combination with TMD self-management instructions.
	The patient's TMD symptoms increase with abnormal postural activities.
	The patient desires help in changing poor sleep posture (e.g., stomach sleeping).
Outcome-Oriented	The patient did not obtain adequate TMD symptom relief from initial therapies that did not include physical therapy.
	The patient is to have TMJ surgery; patients who receive physical therapy after TMJ surgery may have significantly better results. It is appropriate for these patients to be referred for physical therapy prior to surgery in order that they may learn about and possibly start the postsurgical exercises, schedule the recommended postsurgical appointments, and receive prior authorization from their insurance carrier.