Short-term evaluation of a standardized pain-school program in patients with TMD pain.

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Short-term evaluation of a standardized pain-school program in patients with TMD pain.

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Title Short-term evaluation of a standardized pain-school program in patients with TMD pain.
Author(s) Ekberg, EwaCarin ; Johnsson, Gunilla ; Millman, Gunilla
Date 2011
English abstract
Introduction: Systematic reviews have concluded that behavioral therapy is effective in treating TMD pain. However, most of the studies included different treatment modes, making it difficult to determine which part of the treatment was most important. It has also been found that patients with TMD pain and major psychological disturbances were in need of a combined therapeutic approach. Aim: The purpose of this descriptive study was to evaluate a standardized pain-school program in patients with TMD pain Material and methods: During 2006 and 2011, 99 patients with TMD pain were referred for treatment with a 5-session pain-school program. The patients were examined according to RDC/TMD, at the Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University. The program consisted of a standardized program where the patients underwent treatment individually for 7 weeks by two special trained dental assistants. Three to four weeks after the last visit an evaluation of the treatment outcome were performed by the same dentist as before treatment. Results: Out of 99 patients 85 patients with a mean age of 39 ± 1.9 years (min 13 years-max 78 years) fulfilled the whole program. Patients fulfilling the program 74 patients were women (mean age 38 years) and 11 were men (mean age 52 years). All patients had at least one pain diagnoses, where 67 patients had myofascial pain, 44 patients had arthralgia/osteoarthritis, 22 patients had headache, and 7 patients had other pain conditions (whiplash, neuralgia, burning mouth syndrome and atypical odontalgia). Most of the patients (74%) had more than one pain diagnosis. 54 patients (67%) were responders and 28 patients were non-responders (33%) to the program. 53 (72%) women and 4 (36%) men reported benefit of the program. Seventy of the patients had had two or more treatments previous to the pain-school, where the most common treatments were information and counseling, and appliance therapy. These treatments had not given sufficient pain relief. In the group having three or more treatments previously 75% of the patients were responders compared to 60% among patients having only information and counseling. Among the 28 non-responders, 5 patients were younger than 20 years of age (10), 7 patients were men (11), 10 patients had high scores of depression according to RDC/TMD (23). Conclusion: This 5-session pain-school intervention seems to be effective in alleviating TMD pain in patients previously treated with usual therapies. The results of this evaluation indicate that there is a need of RCTs evaluating the effectiveness of this program in a short and a long term perspective.
Language eng (iso)
Subject(s) Medicine
Research Subject Categories::ODONTOLOGY
Note Svensk förening för bettfysiologi, Nordiskt möte 2011, Göteborg, 19-21 oktober 2011.
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