IADR Abstract Archives
Risk Factor Based Approach to the Management of Temporomandibular Disorders
Objectives: Temporomandibular joint disorders (TMD) are the most common chronic pain conditions in the orofacial region, and often overlap with other chronic pain conditions such as fibromyalgia, low back pain and headache as well as psychological comorbidities. The contribution of these chronic overlapping pain conditions (COPCs) and other risk factors to disease burden is not known. There is a need for greater understanding of aetiology and risk factors for TMD, to explore how individual patients’ could be more successfully and holistically treated.
In this study we will:
Build on current evidence based knowledge supporting ‘clustering’ of individuals into subgroups based on risk factors for TMD, with focus on COPCs and psychological comorbidities
Determine the percentage of TMD patients who have COPCs and psychological comorbidities
Determine whether success of splint therapy in managing TMD symptoms is the same for patients with and without comorbidities
Methods: Medical history data was collected from dental charts and electronic care records of 412 TMD patients who received a splint for symptoms management. We recorded the presence of the following comorbidities: anxiety/depression, headache, back pain, IBS, fibromyalgia, also taking note of other COPCs. Data was entered in excel sheets and analysed.
Results: 282 out of 412 (68.4%) patients had one or more comorbidity. 41% of patients with no COPCs reported success (‘good’ or ‘improvement’ in symptoms) with use of a splint. 21-27.5% of patients with anxiety/depression, headache, back pain, fibromyalgia, and 35.9% of those with IBS, reported success with splint therapy.
Conclusions: Patients with anxiety/depression, headache, back pain, fibromyalgia COPCs are 13.5% or more, less likely to respond well to splint therapy in terms of symptomatic TMD management. Therefore alternative management may be indicated for such patients, supporting the idea of multidisciplinary management, targeted according to individuals’ risk factors.
In this study we will:
Build on current evidence based knowledge supporting ‘clustering’ of individuals into subgroups based on risk factors for TMD, with focus on COPCs and psychological comorbidities
Determine the percentage of TMD patients who have COPCs and psychological comorbidities
Determine whether success of splint therapy in managing TMD symptoms is the same for patients with and without comorbidities
Methods: Medical history data was collected from dental charts and electronic care records of 412 TMD patients who received a splint for symptoms management. We recorded the presence of the following comorbidities: anxiety/depression, headache, back pain, IBS, fibromyalgia, also taking note of other COPCs. Data was entered in excel sheets and analysed.
Results: 282 out of 412 (68.4%) patients had one or more comorbidity. 41% of patients with no COPCs reported success (‘good’ or ‘improvement’ in symptoms) with use of a splint. 21-27.5% of patients with anxiety/depression, headache, back pain, fibromyalgia, and 35.9% of those with IBS, reported success with splint therapy.
Conclusions: Patients with anxiety/depression, headache, back pain, fibromyalgia COPCs are 13.5% or more, less likely to respond well to splint therapy in terms of symptomatic TMD management. Therefore alternative management may be indicated for such patients, supporting the idea of multidisciplinary management, targeted according to individuals’ risk factors.