How dental teams can help patients with temporomandibular disorders receive general dental care: An International Delphi process

Abstract

Background Many patients with temporomandibular disorders (TMD) find it difficult to undergo dental care due to challenges caused by their condition, previous temporomandibular joint surgery or invasive dental procedures, and the impact of comorbid conditions. Managing routine dental care for some patients with TMD can be seen as challenging by some dental practitioners. Objective The objective of this study was to work with patients experiencing TMD and clinicians to co‐produce recommendations aimed at helping general dentists to provide routine dental care for patients with TMD. Methods A modified Delphi process was used to co‐produce recommendations. Six patients experiencing TMD, patient advocates and seven clinicians took part, including international TMD clinicians. Two meetings were held with patient participants, mediated by a trained facilitator. Recommendations suggested by patient participants were distributed to clinicians who were asked to add additional suggestions, but not to modify patients' recommendations unless to aid clarity. Additional themes were identified from the existing literature, and the recommendations were then reviewed by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) consortium. Results Recommendations were given to support patients before, during and after dental treatment. Participants identified specific and practical recommendations to help patients with TMD receive routine dental care, but also emphasised the need for professionals to listen sensitively to patients' concerns and work with patients in an empathetic and non‐judgmental way. Conclusion These recommendations, co‐developed with patients experiencing TMD, should help dental professionals to provide supportive general dental care for patients with TMD.

Patients’ experiences of temporomandibular disorders and related treatment

“…Since the patients with TMD are managed by different healthcare professionals, the findings from our study are important to acknowledge also in medical settings other than dental healthcare services. These findings, together with previous research from a Delphi study that also included patients experiencing TMD [ 40 ], emphasize the importance of implementing regular dental examinations and providing appropriate support to patients with TMD throughout their healthcare journey.…”

“…In this aspect, inaccurate resource allocation has been identified as a primary cause for inequalities in healthcare in general [ 39 ], and may be related to our findings since the participants described the lack of access to the PDHS in some areas. Further research should explore the priorities and the factors related to the structural organization of the PDHS together with the perspectives of the policy makers [ 40 ]. With regards to providing patient-centred care and positive treatment outcomes, it is highly important that patients with TMD describe positive attitudes towards having an active role in their care seeking process.…”

Sleep Bruxism and Orofacial Pain in Patients with Sleep Disorders: A Controlled Cohort Study

“…Likewise, there is no consensus on a possible connection between SB and Temporomandibular Disorders (TMD); TMDs are highly prevalent musculoskeletal and neuromuscular conditions that affect the temporomandibular joint, masticatory muscles and associated structures [12,13]. Among the proposed treatments, [14][15][16][17], behavioral and physical therapy have been shown to be the most appropriate and effective for the management of TMD [18].…”