Methods: Semi-structured interviews were used to explore both the professional and patient perceptions of TMD, including aspects of their experience of the condition. Two purposive samples (n= 20) were drawn. The first was from a range of dental professionals in primary and secondary care in the U.K. who managed TMD, encompassing all the specialties involved in its management. The second sample was from secondary care patients who had suffered from TMD and had received at least three months of treatment. Data from the professionals' sample informed the patients' topic guide. All data were audio-recorded and transcribed verbatim. The constant comparative method - whereby data collection and analysis occur concurrently until saturation is reached - was used for both samples. The two data sets were then compared.
Results: The main emergent themes were: 1) Pain experience; 2) Identity of complaint; 3) Psychological discomfort. Both patients and professionals identified chronic pain as the chief complaint associated with TMD, but when compared with patients, professionals consistently underestimated its psychosocial effects. Patients also reported that they rarely received a clear diagnosis within primary care, which correlated with a reported reluctance to make a diagnosis within primary care. The combination of pain and the lack of a diagnosis frequently resulted in significant anxiety over the source of their pain. For patients, the diagnosis and the reassurance given in secondary care were crucial to helping them cope with their symptoms.
Conclusion: This study highlights the importance of diagnosis and professional reassurance in the management of patients with TMD. It identifies a requirement for more appropriate training in diagnosis of TMD for both under and postgraduates.