School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK.
J Oral Rehabil. 2023 Jun;50(6):482-487. doi: 10.1111/joor.13444. Epub 2023 Mar 23.
Many patients with temporomandibular disorders (TMD) find it difficult to undergo dental care due to challenges caused by their condition, previous temporomandibular joint surgery or invasive dental procedures, and the impact of comorbid conditions. Managing routine dental care for some patients with TMD can be seen as challenging by some dental practitioners.
The objective of this study was to work with patients experiencing TMD and clinicians to co-produce recommendations aimed at helping general dentists to provide routine dental care for patients with TMD.
A modified Delphi process was used to co-produce recommendations. Six patients experiencing TMD, patient advocates and seven clinicians took part, including international TMD clinicians. Two meetings were held with patient participants, mediated by a trained facilitator. Recommendations suggested by patient participants were distributed to clinicians who were asked to add additional suggestions, but not to modify patients' recommendations unless to aid clarity. Additional themes were identified from the existing literature, and the recommendations were then reviewed by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) consortium.
Recommendations were given to support patients before, during and after dental treatment. Participants identified specific and practical recommendations to help patients with TMD receive routine dental care, but also emphasised the need for professionals to listen sensitively to patients' concerns and work with patients in an empathetic and non-judgmental way.
These recommendations, co-developed with patients experiencing TMD, should help dental professionals to provide supportive general dental care for patients with TMD.
许多患有颞下颌关节紊乱（TMD）的患者由于其病情、先前的颞下颌关节手术或侵入性牙科手术以及合并症的影响，难以接受牙科护理。一些牙科从业者认为，管理一些 TMD 患者的常规牙科护理具有挑战性。
本研究的目的是与患有 TMD 的患者和临床医生合作，共同制定旨在帮助全科牙医为 TMD 患者提供常规牙科护理的建议。
使用改良 Delphi 流程共同制定建议。六名患有 TMD 的患者、患者权益倡导者和七名临床医生参与其中，包括国际 TMD 临床医生。患者参与者进行了两次会议，由经过培训的主持人主持。患者参与者提出的建议分发给临床医生，临床医生被要求提出其他建议，但不得修改患者的建议，除非有助于澄清。从现有文献中确定了其他主题，然后由国际口面疼痛和相关障碍方法学（INfORM）联盟审查建议。
建议在牙科治疗前后为患者提供支持。参与者提出了具体实用的建议，以帮助 TMD 患者接受常规牙科护理，但也强调专业人员需要敏感地倾听患者的担忧，并以同情和非评判的方式与患者合作。
这些建议是与患有 TMD 的患者共同制定的，应该有助于牙科专业人员为 TMD 患者提供支持性的常规牙科护理。
