Seeking treatment for temporomandibular disorders: What patients can expect from non-dental health care providers

Background Understanding the profile of the individual complaining of TMJ clicking can help in the clinical approach of these patients. Objective To identify clinical variables associated with individuals who complain about and seek treatment for TMJ clicking. Methods Seventy‐two individuals, composed the sample: Group 1 – patients with a complaint of TMJ clicking who sought treatment; (n = 36); Group 2 – individuals with TMJ clicking who have no complaints about it (n = 36). Three categories of data were evaluated: clinical (gender; age; side of TMJ clicking; TMJ pain; self‐reported level of bother; previous TMJ clicking information); somatosensory (mechanical pain threshold [MPT], wind‐up ratio [WUR], pressure pain threshold [PPT]); and, psychosocial (Pain Vigilance and Awareness Questionnaire [PVAQ]; Pain Catastrophising Scale [PCS]; Tampa Scale for Kinesiophobia for Temporomandibular Disorders [TSK/TMD]); The Perceived Stress Scale (PSS); The State‐Trait Anxiety Inventory (STAI). Results Group 1 was composed mostly of female patients, with TMJ pain, without previous orientation about the condition, bothered by the clicking, with lower PPT and higher scores in the PVAQ, PCS, TKS/TMD, PSS and STAI scales than Group 2. The groups did not differ significantly for side of TMJ clicking, age, MPT and WUR. Conclusion Individuals who have a TMJ clicking complaint and seek treatment are mostly female, have TMJ pain, have not received previous orientation about TMJ clicking, are bothered by the clicking, have a lower pain threshold and higher scores of hypervigilance, catastrophising, kinesiophobia, stress and anxiety than people with TMJ clicking who do not report it.

Section: Discussionsupporting

confidence: 89%

Who is the individual that will complain about temporomandibular joint clicking?

Poluha

Canales

Bonjardim

et al. 2022

“…In the last decade, the results from systematic reviews have supported the effectiveness of physical therapy in managing people with TMDs with an adequate level of evidence 8,9,18–20 . This knowledge has contributed to making physical therapy one of the most common treatments for the successful management of TMDs 8 also because a physical therapy approach fits with TMD treatment recommendation (eg conservative, evidence based, promoting behaviour changes) 55 . However, additional studies are required to determine the most effective form or combination of physical therapy interventions (eg strengthening exercises, stretching exercises or MT).…”

Section: Discussionmentioning

confidence: 99%

“…8,9,[18][19][20] This knowledge has contributed to making physical therapy one of the most common treatments for the successful management of TMDs 8 also because a physical therapy approach fits with TMD treatment recommendation (eg conservative, evidence based, promoting behaviour changes). 55…”

Section: F I G U R E 2 Risk Of Bias 2 Summary Of Risk Of Bias For Eac...mentioning

confidence: 99%

Effectiveness of manual therapy applied to craniomandibular structures in temporomandibular disorders: A systematic review

Asquini

Pitance

Michelotti

et al. 2022

“…3,4 This in turn may be driven by the lack of understanding and experience of various healthcare professionals concerning appropriate evidence based management of TMD, as well as inconsistencies in professional training related to TMD. [5][6][7][8] Factors of cost that can differentially affect the course of resolution of TMD symptoms involve comorbidities that can affect the resolution of typical TMD symptoms and factors associated with developing a chronic persistent pain condition. Over 30 comorbidities have been considered to be associated with TMD.…”

Section: Introductionmentioning

confidence: 99%

Predicting the number of physical therapy visits and patient satisfaction in individuals with temporomandibular disorder: A cohort study

Prodoehl

Kraus²,

Stein

2021

Background Temporomandibular disorders (TMD) can be challenging to manage for clinicians and patients alike. It is unclear which factors are associated with prolonging conservative care and patient dissatisfaction with treatment outcomes. Objectives To examine factors collected during a physical therapy (PT) evaluation in a cohort of individuals with TMD to determine factors associated with an increased number of PT visits and reduced patient satisfaction. Methods Records of 511 patients referred to PT over 18 months were reviewed to extract 27 variables to develop a predictive model. Outcomes were patient satisfaction following PT and number of PT visits. Linear and zero inflated negative binomial regressions were used, and a multivariate regression model was built for both outcomes. Results Two factors were associated with both lower patient satisfaction and an increased number of PT visits: higher patient rated functional neck disability and a greater number of healthcare professionals seen. Other factors associated with patient satisfaction were duration of symptoms, subluxation, and referral from an oral surgeon. Only patient rated functional neck disability score was a significant predictive factor in the multivariate model. Factors associated with number of PT visits were gender, educational level, time between initial visit and discharge, number of pain areas, bruxism, biopsychosocial factors, dizziness, pain rating, and presence of neck pain. In the multivariate model, gender, number of healthcare professionals seen, and resting pain rating were significant predictors of number of PT visits. Conclusion Considering key factors on initial evaluation, specifically functional neck disability and the number of prior healthcare professionals seen before starting PT, can help to predict a higher number of PT visits and reduced patient satisfaction with outcomes.