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The TMD management dilemma

British Dental Journal volume 236, pages 949–954 (2024)Cite this article

Abstract

As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both sectors. The authors aim to explore the dilemma of TMD management as the patient journeys through from primary to secondary care and offer educational tools to support practitioners in managing this complex patient cohort, as well as outlining alternative solutions for the delivery of TMD management strategies.

Key points

  • Both primary and secondary care sectors are faced with challenges in the management of patients with temporomandibular disorders (TMDs), mutually including resource availability and patient expectations.

  • Improving the knowledge and confidence of general dental practitioners in managing TMDs in primary care is paramount and the paper presents a novel visual aid to support this, with an emphasis on psychosocial aspects.

  • Group therapy for the management of myofascial TMD pain in secondary care presents a cost-effective way of managing this cohort, with high levels of patient satisfaction reported.

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Author information

Authors and Affiliations

  1. Consultant Oral Surgeon, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK

    Marianne Henien, Chris Sproat & Anna Maciag

  2. Specialist Oral Surgeon, Department of Oral Surgery, Birmingham Dental Hospital, UK

    Lara Zebic

  3. Academic Clinical Fellow in Oral Surgery, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK

    Krishantini Mahendran

  4. Speciality Dentist in Oral Surgery, Department of Oral Surgery, Guy´s and St Thomas´ NHS Foundation Trust, UK

    Amy Mellor

Authors
  1. Marianne Henien
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  2. Lara Zebic
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  3. Krishantini Mahendran
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  4. Amy Mellor
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  5. Chris Sproat
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  6. Anna Maciag
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Contributions

Marianne Henien: conceptualisation, writing original draft, review and editing of subsequent drafts, and construction of visual educational tool. Lara Zebic: construction of visual educational tool and review and editing drafts. Krishantini Mahendran and Amy Mellor: writing of original draft. Chris Sproat and Anna Maciag: supervision and review and edit of drafts.

Corresponding author

Correspondence to Marianne Henien.

Ethics declarations

The authors declare no conflicts of interest.

The study in Box 1 did not require ethics approval in line with HRA Ethical Approval tool, with the survey being anonymous and no patient-identifiable information being captured, and the survey participants were NHS healthcare staff members. The survey introduction highlighted to participants that data gathered may be published in the future and completion implied consent. Consent was obtained to approve the use of any results and comments. The study in Box 2 did not require ethical approval as this is a service evaluation collecting PROMs as part of routine clinical practice. Consent was obtained for participation and for the use of results/comments.

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Henien, M., Zebic, L., Mahendran, K. et al. The TMD management dilemma. Br Dent J 236, 949–954 (2024). https://doi.org/10.1038/s41415-024-7506-5

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