J Am Dent Assoc. 2022 Feb;153(2):144-157. doi: 10.1016/j.adaj.2021.07.027. Epub 2021 Dec 29.
Patients often seek consultation with dentists for temporomandibular disorders (TMDs). The objectives of this article were to describe the methods of a large prospective cohort study of painful TMD management, practitioners' and patients' characteristics, and practitioners' initial treatment recommendations conducted by The National Dental Practice-Based Research Network (the "network").
Participating dentists recruited into this study treated patients seeking treatment for painful TMDs. The authors developed self-report instruments based on well-accepted instruments. The authors collected demographics, biopsychosocial characteristics, TMD symptoms, diagnoses, treatments, treatment adherence, and painful TMDs and jaw function outcomes through 6 months.
Participating dentists were predominately White (76.8%) and male (62.2%), had a mean age of 52 years, and were general practitioners (73.5%) with 23.8% having completed an orofacial pain residency. Of the 1,901 patients with painful TMDs recruited, the predominant demographics were White (84.3%) and female (83.3%). Patients' mean age was 44 years, 88.8% self-reported good to excellent health, and 85.9% had education beyond high school. Eighty-two percent had pain or stiffness of the jaw on awakening, and 40.3% had low-intensity pain. The most frequent diagnoses were myalgia (72.4%) and headache attributed to TMDs (51.0%). Self-care instruction (89.4%), intraoral appliances (75.4%), and medications (57.6%) were recommended frequently.
The characteristics of this TMD cohort include those typical of US patients with painful TMDs. Network practitioners typically managed TMDs using conservative treatments.
This study provides credible data regarding painful TMDs and TMD management provided by network practitioners across the United States. Knowledge acquired of treatment recommendations and patient reports may support future research and improve dental school curricula.
患者经常因颞下颌关节紊乱（TMD）寻求牙医咨询。本文的目的是描述一项大型前瞻性队列研究的方法，该研究针对的是 TMD 疼痛的管理、从业者和患者的特征以及美国国家牙科实践为基础的研究网络（该“网络”）的从业者的初始治疗建议。
参与本研究的牙医招募了因 TMD 疼痛寻求治疗的患者。作者根据公认的仪器开发了自我报告工具。作者通过 6 个月收集人口统计学、生物心理社会特征、TMD 症状、诊断、治疗、治疗依从性以及 TMD 和颌功能的结果。
参与的牙医主要是白人（76.8%）和男性（62.2%），平均年龄为 52 岁，是普通从业者（73.5%），其中 23.8%完成了口腔疼痛住院医师培训。在 1901 名患有 TMD 疼痛的患者中，主要的人口统计学特征是白人（84.3%）和女性（83.3%）。患者的平均年龄为 44 岁，88.8%自我报告健康状况良好或优秀，85.9%接受过高中以上教育。82%的患者在醒来时出现颌痛或僵硬，40.3%的患者有低强度疼痛。最常见的诊断是肌痛（72.4%）和 TMD 引起的头痛（51.0%）。自我护理指导（89.4%）、口腔内器械（75.4%）和药物（57.6%）被频繁推荐。
该 TMD 队列的特征包括美国 TMD 疼痛患者的典型特征。网络从业者通常采用保守治疗来治疗 TMD。
本研究提供了有关美国网络从业者治疗 TMD 疼痛和 TMD 的可靠数据。对治疗建议和患者报告的了解可能支持未来的研究并改进牙科学院的课程。
