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Pain-related temporomandibular disorder – current perspectives and evidence-based management Supriya Ghurye Roddy McMillan Dental Update 2024 42:6, 707-709.
Authors
SupriyaGhurye
BDS, MJDF RCS(Eng)
Oral Medicine CDT, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Oral Medicine Department, Floor 22 Tower Wing, Great Maze Pond, London, SE1 9RT
Pain-related temporomandibular disorder (TMD) is one of the top three most common chronic pain conditions, along with headaches and back pain. TMD has complex pathophysiology and significant associations with a variety of other chronic pain conditions, eg fibromyalgia, irritable bowel syndrome and migraine. Chronic TMD is associated with a negative impact upon quality of life and high levels of healthcare utility. It is important that clinicians are able to diagnose TMD correctly, provide appropriate management in keeping with current evidence-based practice, and identify when to refer patients to specialist care. The presence of risk factors, eg anxiety, depression, pain-related disability and chronic pain conditions elsewhere in the body, may help to identify which TMD patients require referral for multidisciplinary management. TMD should be managed using a holistic approach, incorporating patient education and encouragement towards self-management. TMD care pathways should consider using the three ‘pillars’ of pain management: physical therapies, pharmacotherapy and clinical psychology.
CPD/Clinical Relevance: TMD is associated with considerable comorbidity and significant negative impact upon quality of life. It therefore follows that dental practitioners should keep up-to-date with the recent scientific evidence and recommendations relating to the diagnosis and management of TMD.
Article
Temporomandibular disorders are a group of musculoskeletal disorders which constitute the most common cause of non-dental orofacial pain in the head and neck region.1 TMD sits alongside chronic back pain and headaches, as one of the three most common chronic pain conditions.1 The reported prevalence of TMD is between 5–50% of the general population.1 A survey by Durham et al2 in 2007, reported that dentists in primary care reported uncertainty with regards to the diagnosis of TMD, and thus had a low threshold for referral to secondary care. Patients with TMD often first present to their general dental practitioner, and therefore it is important that clinicians in primary dental care are able to identify TMD correctly and instigate appropriate management. Moreover, clinicians should also be able to identify patients with chronic TMD, or risk factors for developing chronic pain, who may require referral to specialist services.
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