Initial Management for Painful TMJD: A CONDOR Dental PBRN Survey

Objectives: To: (1) describe the initial management for painful temporomandibular muscle and joint disorders (TMJD) provided by clinicians in the three dental Practice-Based Research Networks (PBRNs); and (2) ascertain their interest in conducting a randomized clinical trial (RCT) to assess the effectiveness of their initial treatments. Methods: A survey regarding initial care for patients with painful TMJD was sent to all dentists in the 3 PBRNs. Descriptive analyses were performed (SAS 9.1). Results: The survey was completed by 862 dentists: 70% male, 86% non-Hispanic-white, mean age 52, (SD: 12) and 91% were general dentists. Dentists provided initial care for 82% of their TMJD patients (average 3 patients/month) while 79% also referred patients for treatment (average 1 patient/month). Dentists reported that 42% of their patients had mild or moderate pain and 54% had acute pain (duration < 6 months). Frequently reported symptoms were jaw (87%) or facial pain (66%), and TMJ noises (75%). For initial management of painful TMJD, the most frequent interventions were home-based self-care (81%), splint therapy (70%), or over-the-counter medication (69%). Eighty percent of the dentists were willing to participate in an RCT, 90% were motivated to help generate data and 79% wanted to give back to the profession. The preferred treatments to be studied were splint therapy (35%) and self-care (28%). Cost was identified as a barrier for using the test treatment(s) by 22%. Conclusion: Reversible initial care is typically provided for painful TMJD. The results also suggest that it would be feasible to conduct an RCT in the PBRNs for assessing the effectiveness of self-care, splint therapy and/or medications for the initial management of painful TMJD. Support: DE016750, DE016752, DE016754, DE016755, DE016746, DE016747. CONDOR (Collaboration on Networked Dental and Oral Health Research), trans-PBRN entity of three NIDCR-funded PBRNs.