Mobile SMS-Based Intervention on Temporomandibular Disorder Treatment

Objectives: The TMD refers to a set of conditions that occur in the orofacial region that compromise the comfort and normal functioning of the hard and soft tissues of the masticatory system¹. This study focus on assessing the impact of system based on mobile phone SMS use during treatment in terms of adherence.

Methods: The development of web system used in this study, DTM Alert System, is based on an existing model². A randomized controlled trial was conducted at the TMD and orofacial pain outpatient clinic at Universidade Federal de São Paulo (UNIFESP). The population consisted of 38 patients, selected according to inclusion and exclusion criteria and allocated randomly into two groups. The control group (n=19) received standard treatment and the intervention group (n=19) received standard treatment plus SMS reminders. Each patient was followed up for three months and adherence was measured by assessing the patient`s clinical evolution through objective variables (vertical extent of mouth opening, right, left maximum bite force) and visual analog pain scale (VAS) subjective variable. Non-attendance related to follow-up visits and satisfaction questionnaires regarding the delivery and outpatient care were also assessed.This study was approved by Brazilian Ethics Committee SISNEP (# 2135/11).
Results: The DTM Alert System was tested and approved as a project platform for inpatient SMS communication. The tests included message delivery likelihood, system usability and messages content analysis. A descriptive data analysis was carried out. The mouth opening average values, maximum bite force and VAS in the intervention group had a better average when compared to the control group (12% vs. 6%; 11% vs. -12%; 78% vs. 46% improvement respectively). The percentage of control group non-attendance was 22%, while the percentage of the intervention group non-attendance was 11%. The responses to the satisfaction survey were positive.


Conclusions: The system was considered useful and feasible for use in the outpatient clinic where the research was carried out. The results related to the clinic evolution variables and non-attendance suggest that the support offered by SMS reminders had a positive impact in the TMD symptoms and adherence to treatment.