Ajith D Polonowita1, W Murray Thomson2, Dennis N Thorburn3. 1. Oral Medicine Specialist, Christchurch Hospital, NZ; Head of Discipline in Oral Medicine, The University of Otago, Dunedin, New Zealand. Electronic address: aporalmed@gmail.com. 2. Professor of Dental Epidemiology and Public Health, The University of Otago, Dunedin, New Zealand. 3. Formerly Oral Medicine specialist, Christchurch Hospital, New Zealand.
Abstract
OBJECTIVE: Chronic temporomandibular disorder (cTMD) produces orofacial pain and limited jaw function and impacts on quality of life. A clinical case series of patients referred to a hospital specialist service is described here. STUDY DESIGN: In a 1-year consecutive case series of 162 patients with cTMDs, each patient had been managed with self-awareness and jaw exercises, as well as oral appliances. Pain severity and chewing function were scored by using a visual analogue scale (VAS), and quality of life was assessed by using the Oral Health Impact Profile-Temporomandibular Dysfunction (OHIP-TMD). RESULTS: Females comprised 87% (average age 49 years). Treatment time averaged 20.8 months, and the average pain duration was 2.8 years. The mean VAS pain score fell from 6.9 (standard deviation [SD] 1.6) to 2.0 (SD 1.9) after treatment, giving a "large" effect size of 3.1. Chewing difficulty improvement also showed a "large" effect size (2.5). For the 33 patients for whom longitudinal OHIP-TMD data were available, the mean pretreatment and posttreatment scores of 51.2 (SD 20.9) and 26.2 (SD 17.7) showed a "large" effect size of 1.2. CONCLUSIONS: A simple noninvasive protocol for managing cTMD with self-help, exercises, and oral devices resulted in clinically and statistically meaningful improvements in pain, function, and quality of life.
OBJECTIVE:Chronic temporomandibular disorder (cTMD) produces orofacial pain and limited jaw function and impacts on quality of life. A clinical case series of patients referred to a hospital specialist service is described here. STUDY DESIGN: In a 1-year consecutive case series of 162 patients with cTMDs, each patient had been managed with self-awareness and jaw exercises, as well as oral appliances. Pain severity and chewing function were scored by using a visual analogue scale (VAS), and quality of life was assessed by using the Oral Health Impact Profile-Temporomandibular Dysfunction (OHIP-TMD). RESULTS: Females comprised 87% (average age 49 years). Treatment time averaged 20.8 months, and the average pain duration was 2.8 years. The mean VAS pain score fell from 6.9 (standard deviation [SD] 1.6) to 2.0 (SD 1.9) after treatment, giving a "large" effect size of 3.1. Chewing difficulty improvement also showed a "large" effect size (2.5). For the 33 patients for whom longitudinal OHIP-TMD data were available, the mean pretreatment and posttreatment scores of 51.2 (SD 20.9) and 26.2 (SD 17.7) showed a "large" effect size of 1.2. CONCLUSIONS: A simple noninvasive protocol for managing cTMD with self-help, exercises, and oral devices resulted in clinically and statistically meaningful improvements in pain, function, and quality of life.
Authors: Miguel Pais Clemente; Asdrúbal Pinto; Fernando Milheiro; Teresa F Costa; Andre Moreira; Ricardo Vardasca; Pedro A Pereira; Joaquim Mendes; M Dulce Madeira; José Manuel Amarante Journal: J Oral Biol Craniofac Res Date: 2020-01-18