Knowledge and Beliefs Regarding TMD: Has Anything Changed After 20 Years?

Abstract

Background: Due to the variety of factors involved in TMDs it is not surprising to see a wide range of treatment modalities being suggested for TMD patients. However, one determinant of treatment for TMD that is often overlooked is the practitioner's knowledge and beliefs about the syndrome itself. Objectives: To evaluate changes in experts' knowledge and beliefs regarding Temporomandibular Disorders (TMD) since the administration of the first such survey by Le Resche, Truelove and Dworkin in 1993. Patients and Methods: A survey invitation was emailed to 62 dentists and 19 psychologists, all determined to be experts in the orofacial pain/TMD field. All dentists selected to be part of this survey were members of the American Academy of Orofacial Pain. Psychologists were selected based on their publications in this field. The Le Resche et al. questionnaire was used with the following adaptations: four new statements were inserted; one statement was removed; and a 6-point Likert agreement scale for each statement was used instead of the original 11-point scale. Reminder emails were sent at one week and one month to maximize the response rate. Changes in responses to each item from the original survey were assessed using z-test. Results: Thirty-four dentists but only three psychologists responded to the survey. Therefore only responses from dentists were used in the analysis. Overall there was a high level of agreement between the original sample and the current sample. Of the 34 original items there was very clear consensus on 24. There was consensus on two new items in the survey on the need for a tomogram and splint therapy. Conclusions: Twenty years after the original survey, the knowledge and beliefs regarding TMDs among experts in this field have not changed significantly.

Stress‐evoked muscle activity in women with and without chronic myofascial face pain

“…Theory predicts, and oro‐facial pain specialists and MFP patients generally believe, 15–17 that stressors lead to increased muscle activity, which leads to muscle‐specific pain in vulnerable individuals 1,9,10,33 . In this study, we induced distress through several common stressor tasks and evaluated changes in EMG amplitude.…”

“…Further, while this question has a venerable scientific history, it remains most relevant because several generations of dentists and oro‐facial pain specialist have, at least since the time of Schwartz 13 and Laskin 14 half a century ago, believed that environmental stressors will increase masticatory muscle activity, leading to increased pain in vulnerable patients. LeResche and colleagues 15 first showed this belief was prevalent among dentists, and recent reports confirm that this belief continues among dentists 16 and even patients 17 …”