This study aimed to assess how temporomandibular disorder (TMD) diagnostics are integrated into routine orthodontic care and to explore how identified TMD symptoms influence treatment planning and therapy decisions. A survey was distributed to all officially registered orthodontists in Germany, collecting information on their professional experience, TMD-related specialization, and specific clinical practices. Responses were anonymized, organized, manually verified, and statistically analyzed. Fisher’s exact tests were used to evaluate differences in TMD-related procedures based on professional experience and specialization. Out of 2,359 questionnaires sent, 630 were completed and analyzed. Most respondents reported performing either a brief TMD screening or a comprehensive functional assessment. Only 21.1% rely solely on patient medical history for evaluation. A secondary full functional assessment was conducted by 33% during ongoing orthodontic treatment and by 56.6% only when initial findings indicated pathology. Non-painful temporomandibular joint (TMJ) clicking identified prior to therapy influenced treatment planning in 60.1% of respondents. Merely 4.3% reported taking no further action when TMD symptoms were present before treatment. While professional experience did not significantly affect diagnostic procedures, a specialization in TMDs did. The findings reveal a gap between research evidence and routine practice in German orthodontics, potentially leading to more extensive TMD evaluations, which, however, do not pose adverse health effects for patients.
