Patients with temporomandibular disorders (TMD) can become very complex. This article aims to highlight the importance of the multimodal and multidisciplinary approach in this type of patients to improve clinical outcomes. At present we have innumerable techniques and tools to approach this type of patients from a biopsychosocial model where active and adaptive type treatments are fundamental. There are various health professions that have competence in the treatment of TMD, however, although in the most complex cases should be treated simultaneously, still too many patients receive unique treatments and only from one point of view. This review exposes the treatments available from a clinical-scientific perspective and also emphasizes the importance of working in specialized units with those professionals who have competencies on the different conditions that may occur.

BackgroundThe aim of the present study was to describe and compare the oral and dental health status of two groups, one diagnosed with eating disorders (EDs), and another group without this pathology, assessing the following oral manifestations: dental alterations, periodontal disorders, soft tissue disorders, non-stimulated salivary flow, and oral pH.Material and MethodsThis comparative transversal epidemiological study included 179 participants, of whom 59 were diagnosed with EDs (Eating Disorder Group: EDG) and 120 had no antecedents of EDs (No Eating Disorder Group: NEDG). All patients fulfilled the following inclusion criteria: women aged over 18 years, diagnosed with an ED by a specialist, patients who had undergone at least 1 year monitoring by the Clinical Nutrition Unit, and had not received any periodontal treatment during the previous 6 months. Both groups were homogeneous in terms of sex, age, education, and socioeconomic level. Oral exploration was performed, registering clinical variables, as well as sociodemographic and socioeconomic data, oral hygiene habits, and smoking. Statistical significance was established as p<0.05 (confidence level > 95%).ResultsThe dental erosion (DE) was the most significative feature of dental alterations. The degree of DE was significantly greater in the EDG (p<0.001). A significant association between soft tissue lesions and EDs was found (p<0.001) A notable difference in non-stimulated salivary flow was found between the groups (p<0.001). No significant differences between the groups were found for periodontal status, dental caries, or oral hygiene practices.ConclusionsOn the basis of the results obtained, it is necessary to carry out oral/dental examination as soon as an ED is diagnosed with regular check-ups thereafter. Key words:Eating disorders, anorexia nervosa, bulimia nervosa, oral health, dental erosion.

The aim of this study was to assess the ability of students at the School of Dentistry, Complutense University of Madrid, Spain, to diagnose oral cancer and other potentially malignant disorders, as well as to compare their ability at different stages of the learning process and evaluate their knowledge retention. Students were surveyed after they had studied oral medicine and oral pathology at two time points: midway through and near the end of their studies. The survey consisted of questions about 40 photographs of benign oral lesions, malignant oral lesions, and potentially malignant disorders. The response rate for all groups was greater than 70%. The results showed that these students' overall success rate in differentiating benign from malignant lesions averaged 73.9%. When the distinction for potentially malignant disorders was included, their average overall success rate decreased to 42.8% (p<0.001). Furthermore, the students' average success rate was at its lowest at the end of the dental program (p<0.001). Results from this study suggest that, given these students' dificulties in identifying potentially malignant disorders, an increased emphasis on cancer education in the dental curriculum may be needed for future practitioners to master this ability.Dr. Cerero-Lapiedra is Professor,

The pattern of lip cancer reported to Public Hospitals of Madrid is changing: declining rates are noted since 2001-02. However, it is necessary to monitor these data to confirm the observed trends in future years.

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Background: Patients suffering pain related temporomandibular disorders (TMD) exhibit greater levels of psychological distress, environmental stress, somatic symptoms, anxiety, depression, somatic awareness, pain catastrophizing, and impaired pain coping strategies compared to pain-free controls. However, little is known about psychological factors involved in the different TMD types fulfilling DC/TMD criteria. Furthermore, regardless of severity, the role of general coping strategies and styles in TMD is not yet well understood. The main goal of this study was to investigate stress-related coping styles, anxiety and personality traits in a group of dentistry students suffering from temporomandibular disorder with myalgia. Methods: A cohort of 102 university students was initially recruited for this study. Following clinical evaluation, a myalgia group (24 participants) and a control group (25 participants) were formed. Participants were later assessed in anxiety, stress coping strategies, and personality measures by using the State-trait anxiety inventory (STAI), coping response inventory (CRI), and Neo Five-Factor Inventory (NEO-FFI) questionnaires respectively. Results: The myalgia group presented greater levels of trait anxiety and neuroticism in comparison to the control group. In addition, participants with myalgia showed higher levels of avoidance coping. Conclusions: Avoidance coping strategies are generally considered maladaptive, as they seem to increase perceived stress, a robust predictor of TMD. Interventions aimed at reducing stress levels and preventing maladaptive coping styles, might improve temporomandibular health and prevent the myalgia and its chronification.

Background: Patients suffering pain related temporomandibular disorders (TMD) exhibit greater levels of psychological distress, environmental stress, somatic symptoms, anxiety, depression, somatic awareness, pain catastrophizing, and pain coping strategies compared to pain-free controls. However, little is known about psychological factors involved in the different TMD types fulfilling DC/TMD criteria. Furthermore, regardless of the severity, the role of general coping strategies and styles in TMD is not yet well understood. The main goal of this study was to investigate anxiety, personality traits, and coping behavior in a group of dentistry students suffering from temporomandibular disorder with myalgia. Methods: A cohort of 102 university students was initially recruited for this study. Following clinical evaluation, a myalgia group (24 participants) and a control group (25 participants) were formed. Participants were later assessed in anxiety, stress coping strategies, and personality measures by using the State-trait anxiety inventory (STAI), coping response inventory (CRI), and Neo Five-Factor Inventory (NEO-FFI) questionnaires respectively. Results: The myalgia group presented greater levels of trait anxiety and neuroticism in comparison to the control group. In addition, participants with myalgia showed higher levels of avoidance coping. Conclusions: Avoidance coping strategies are generally considered maladaptive, as they seem to increase perceived stress, a robust predictor of TMD. Interventions to reduce stress levels and prevent maladaptive coping styles, might improve temporomandibular health and prevent the myalgia and its chronification.

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