AIMS: To carry out a randomized clinical trial (RCT) contrasting usual conservative treatment of TMD by clinical TMD specialists with a structured self-care intervention, targeted to clinic cases independent of TMD physical diagnosis, who were reporting minimal levels of psychosocial dysfunction; the intervention was delivered by dental hygienists in lieu of usual treatment. METHODS: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used to target subjects who exhibited minimal TMD-related psychosocial interference. Criteria for study inclusion were: (1) self-report of facial and/or masticatory muscle pain discomfort for which usual care was prescribed by the clinic TMD specialist; (2) RDC/TMDAxis II graded scale of chronic pain (GCP) score of 0, I, or II-Low. (3) Age 18 to 70 years. RESULTS: On 1-year follow-up, while both groups showed improvement in all clinical and self-report categories measured, patients in the tailored self-care treatment program compared to usual TMD treatment showed significantly; (a) decreased TMD pain, (b) decreased pain-related interference in activity; (c) reduced number of masticatory muscles painful; (d) fewer additional visits for TMD treatment. Groups were comparable with regard to measures of vertical range of motion. The self-care program was associated with consistent, but non-statistically significant, trends towards lower levels of depression and somatization. Ability to cope with TMD, knowledge concerning TMD and patient satisfaction was significantly enhanced for the self-care group. No participating patients experienced physical or personal adverse effects during the 1-year post-treatment follow-up period. CONCLUSION: Use of RDC/TMD psychosocial assessment criteria can contribute to successful clinical decision-making for the management of TMD.
RCT Entities:
AIMS: To carry out a randomized clinical trial (RCT) contrasting usual conservative treatment of TMD by clinical TMD specialists with a structured self-care intervention, targeted to clinic cases independent of TMD physical diagnosis, who were reporting minimal levels of psychosocial dysfunction; the intervention was delivered by dental hygienists in lieu of usual treatment. METHODS: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used to target subjects who exhibited minimal TMD-related psychosocial interference. Criteria for study inclusion were: (1) self-report of facial and/or masticatory muscle pain discomfort for which usual care was prescribed by the clinic TMD specialist; (2) RDC/TMD Axis II graded scale of chronic pain (GCP) score of 0, I, or II-Low. (3) Age 18 to 70 years. RESULTS: On 1-year follow-up, while both groups showed improvement in all clinical and self-report categories measured, patients in the tailored self-care treatment program compared to usual TMD treatment showed significantly; (a) decreased TMD pain, (b) decreased pain-related interference in activity; (c) reduced number of masticatory muscles painful; (d) fewer additional visits for TMD treatment. Groups were comparable with regard to measures of vertical range of motion. The self-care program was associated with consistent, but non-statistically significant, trends towards lower levels of depression and somatization. Ability to cope with TMD, knowledge concerning TMD and patient satisfaction was significantly enhanced for the self-care group. No participating patients experienced physical or personal adverse effects during the 1-year post-treatment follow-up period. CONCLUSION: Use of RDC/TMD psychosocial assessment criteria can contribute to successful clinical decision-making for the management of TMD.
Authors: Kristin R Archer; Clinton J Devin; Susan W Vanston; Tatsuki Koyama; Sharon E Phillips; Shannon L Mathis; Steven Z George; Matthew J McGirt; Dan M Spengler; Oran S Aaronson; Joseph S Cheng; Stephen T Wegener Journal: J Pain Date: 2015-10-23 Impact factor: 5.820
Authors: Eric Schiffman; Richard Ohrbach; Edmond Truelove; John Look; Gary Anderson; Jean-Paul Goulet; Thomas List; Peter Svensson; Yoly Gonzalez; Frank Lobbezoo; Ambra Michelotti; Sharon L Brooks; Werner Ceusters; Mark Drangsholt; Dominik Ettlin; Charly Gaul; Louis J Goldberg; Jennifer A Haythornthwaite; Lars Hollender; Rigmor Jensen; Mike T John; Antoon De Laat; Reny de Leeuw; William Maixner; Marylee van der Meulen; Greg M Murray; Donald R Nixdorf; Sandro Palla; Arne Petersson; Paul Pionchon; Barry Smith; Corine M Visscher; Joanna Zakrzewska; Samuel F Dworkin Journal: J Oral Facial Pain Headache Date: 2014
Authors: Cheryl Ritenbaugh; Richard Hammerschlag; Samuel F Dworkin; Mikel G Aickin; Scott D Mist; Charles R Elder; Richard E Harris Journal: J Pain Date: 2012-10-09 Impact factor: 5.820
Authors: Cheryl Ritenbaugh; Richard Hammerschlag; Carlo Calabrese; Scott Mist; Mikel Aickin; Elizabeth Sutherland; Joseph Leben; Lynn Debar; Charles Elder; Samuel F Dworkin Journal: J Altern Complement Med Date: 2008-06 Impact factor: 2.579