Physical therapy: for TMD patients with difficulty in opening the mouth because of disk displacement. Optimal

use of manually assisted and self mouth-opening exercises with/without NSAIDs administration is recommended after the patient is provided with sufficient information on the disease including disk position (Grade 2B: weak recommendation, moderate-quality evidence) [4]. Occlusal adjustment: for patients with TMD symptoms. The PD0332991 authors recommended against occlusal adjustment for primary treatment (Grade 1D: strong recommendation, very-low-quality evidence). The 3 recommendations were adequate, but a guideline for new clinical questions is warranted in the future. “
“Japan has been implementing a system of public health insurance for the whole nation since April, 1961 [1]. The insurance system covers not only medical treatment but also the majority of dental treatments, with the exception of some kinds of treatment such as orthodontic treatment and dental implants. Most dental clinics therefore conduct treatment click here based on public health insurance criteria. Estimates of national medical care expenditure including dental treatment increased to 36.0 trillion yen in 2009 (Fig. 1) [2]. However, estimates of national

dental care expenditure have not been changed, and the proportion of dental care expenditure in national medical care expenditure has decreased from about 9.8% (1992) to about 7.1% (2009). In addition, both the numbers of dentists and dental clinics have been increased (Fig. 2) [2]. The mean number of dental caries and percentage of people having dental caries has dramatically decreased in recent years in Japan (Fig. 3) [3]. Some magazines and newspapers have pointed out that some dental clinics have closed because of financial problem, and that some dentists are working poor, i.e. working people whose income falls below a given poverty line. The Central Social Insurance Medical Council of the Ministry Lonafarnib manufacturer of Health, Labour

and Welfare, Japan conducts a survey of dental clinic management every other year, and publishes the calculated mean values of the net income, that is, total expenses subtracted from total income, of dental clinics [4]. However, no detailed analyses including investigation of the distribution and change of net income, and factors relating to the net income, have been conducted. Analyses of income and expenses of dental clinics provide useful information for not only managing dental clinics but also policy making. The stability of financial aspects of managing dental clinics is the foundation for safe and appropriate dental treatment. For example, if a dental clinic has financial problems and tries to reduce expenses for medical safety, the number of medical accidents may increase.