Sawicki Caroline M, Sangalli Linda
Department of Pediatric Dentistry and Dental Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL 60515, USA.
Children (Basel). 2024 Sep 26;11(10):1168. doi: 10.3390/children11101168.
BACKGROUND/OBJECTIVES: Pain associated with temporomandibular disorders (TMDs) is the main non-odontogenic cause of orofacial pain among youth. Pediatric dentists are often the first healthcare practitioners to perform a comprehensive oral examination in children, which should include evaluation of the temporomandibular joint, masticatory muscles, and surrounding structures for signs and/or symptoms of TMD. This study assessed pediatric dentists' practice patterns in the screening, diagnosis, and management of TMD.
A 19-item online survey was used to assess pediatric dentists' clinical practice patterns and perceived knowledge and comfort levels in the screening, diagnosis, and management of TMD. The survey was distributed in July 2024, with a one-month window open for the study. Confidence levels and perceived knowledge were compared according to years from graduation and frequency of TMD screening assessment with ANOVA or independent -test, as appropriate. Open-ended items were analyzed thematically.
A total of 206 pediatric dentists and pediatric dentistry residents participated in this study. A share of 72.8% of respondents reported that up to 25% of their patients per week present with signs and symptoms of TMD. About one-fifth of pediatric dental providers never complete a screening history for TMD (22.1%) or a clinical assessment of TMD-related structures (21.6%). There was overall low self-perceived knowledge and confidence among pediatric dentists regarding the diagnosis, screening, and management of TMD in children and adolescents, regardless of the number of years from graduation. Respondents who reported seeing up to 50% of TMD patients reported significantly more knowledge and confidence in diagnosing pediatric TMD than those who encountered fewer TMD patients. An overwhelming majority (81.6%) indicated a need for continuing education courses and training focused on the management of TMD in pediatric patients.
Providers reported low confidence and self-perceived knowledge about TMD in pediatric populations, a high rate of referral of patients with TMD, and a particular interest for professional development opportunities focused on management of TMD.
背景/目的:与颞下颌关节紊乱病(TMD)相关的疼痛是青少年口腔颌面疼痛的主要非牙源性原因。儿科牙医通常是首批对儿童进行全面口腔检查的医疗从业者,该检查应包括对颞下颌关节、咀嚼肌及周围结构进行评估,以查找TMD的体征和/或症状。本研究评估了儿科牙医在TMD筛查、诊断和管理方面的执业模式。
采用一项包含19个条目的在线调查,以评估儿科牙医在TMD筛查、诊断和管理方面的临床执业模式以及感知到的知识水平和舒适度。该调查于2024年7月分发,研究为期一个月。根据毕业年限和TMD筛查评估频率,采用方差分析或独立样本t检验(视情况而定)比较置信水平和感知到的知识。对开放式问题进行主题分析。
共有206名儿科牙医和儿科牙科住院医师参与了本研究。72.8%的受访者报告称,每周高达25%的患者出现TMD的体征和症状。约五分之一的儿科牙科从业者从未完成TMD的筛查病史(22.1%)或对TMD相关结构的临床评估(21.6%)。无论毕业年限如何,儿科牙医对儿童和青少年TMD的诊断、筛查和管理总体自我感知知识和信心较低。报告看过高达50%的TMD患者的受访者在诊断儿科TMD方面的知识和信心明显高于看过较少TMD患者的受访者。绝大多数(81.6%)表示需要针对儿科患者TMD管理的继续教育课程和培训。
从业者报告称,对儿科人群TMD的信心和自我感知知识较低,TMD患者转诊率高,并且对专注于TMD管理的专业发展机会有着特别的兴趣。