IADR Abstract Archives
Keynote Address: Too Many Decisions: Uncertainty in Temporomandibular Disorders (TMD)
Objectives: INTRODUCTION/OBJECTIVES:
TMD affect the orofacial region in up to 1 in 15 of the population. Despite being the second most common orofacial pain after ‘toothache’, they still evoke considerable uncertainty felt by clinicians and patients alike. This keynote address will explore both the uncertainty and certainty in how we provide care for those living with TMD.
Methods: METHODS:
Using primary research data from the DEEP study and evidence syntheses, this keynote will explore the uncertainties within the care pathway for TMD, including management techniques.
Results: RESULTS:
Data from a state-funded universal healthcare system demonstrate that TMD result in substantial annual per capita costs: £1254-1810 to healthcare system; £2421-3510 to employers/economy, with the majority incurred through presenteeism; £690-900 to the individual out-of-pocket (2022 prices in pounds sterling). Extrapolating this worldwide to females aged 20-39 with TMD would mean an annual global cost of £701bilion-£1trillion for healthcare systems. Significantly more of these healthcare costs are related to the cost of consultations rather than management/treatment costs (F(2, 2,064) = 109.36 (P < 0.0001)) and link to difficulties in diagnosis and management.
Evidence syntheses of management options for TMD demonstrate wide-ranging results. There are areas of considerable uncertainty in the pharmacological management of TMD but areas of greater certainty on the effectiveness of specific initial management steps for TMD: cognitive behavioural therapy; exercise; supported self-management.
Conclusions: CONCLUSIONS:
Data on care pathways and initial management techniques offer opportunities to set in place foundations for appropriate care for TMD that is likely to reduce the proportion of painful TMD that becomes persistent. There is still some uncertainty in areas, but a substantial step change could be achieved in the quality of care provided to those living with TMD worldwide by implementing standardised initial steps in diagnosis, management, and care pathways.
TMD affect the orofacial region in up to 1 in 15 of the population. Despite being the second most common orofacial pain after ‘toothache’, they still evoke considerable uncertainty felt by clinicians and patients alike. This keynote address will explore both the uncertainty and certainty in how we provide care for those living with TMD.
Methods: METHODS:
Using primary research data from the DEEP study and evidence syntheses, this keynote will explore the uncertainties within the care pathway for TMD, including management techniques.
Results: RESULTS:
Data from a state-funded universal healthcare system demonstrate that TMD result in substantial annual per capita costs: £1254-1810 to healthcare system; £2421-3510 to employers/economy, with the majority incurred through presenteeism; £690-900 to the individual out-of-pocket (2022 prices in pounds sterling). Extrapolating this worldwide to females aged 20-39 with TMD would mean an annual global cost of £701bilion-£1trillion for healthcare systems. Significantly more of these healthcare costs are related to the cost of consultations rather than management/treatment costs (F(2, 2,064) = 109.36 (P < 0.0001)) and link to difficulties in diagnosis and management.
Evidence syntheses of management options for TMD demonstrate wide-ranging results. There are areas of considerable uncertainty in the pharmacological management of TMD but areas of greater certainty on the effectiveness of specific initial management steps for TMD: cognitive behavioural therapy; exercise; supported self-management.
Conclusions: CONCLUSIONS:
Data on care pathways and initial management techniques offer opportunities to set in place foundations for appropriate care for TMD that is likely to reduce the proportion of painful TMD that becomes persistent. There is still some uncertainty in areas, but a substantial step change could be achieved in the quality of care provided to those living with TMD worldwide by implementing standardised initial steps in diagnosis, management, and care pathways.