Management of Painful Temporomandibular Disorders (TMD)


Temporomandibular Disorders (TMD) are the second most commonly occurring musculoskeletal disorders after chronic back pain resulting in pain and disability. Diagnosis and treatment of TMD are within the purview of general dentistry (NIDCR, 2009) with most patients consulting a general dentist regarding their painful TMD. Within the context of the National Dental Practice-Based Research Network (Network), the goal of this observational prospective cohort study is to identify factors contributing to TMD treatment decisions and treatment adherence, as well as the overall effect of TMD treatment on pain intensity and jaw function measured at 1-, 3- and 6-month follow-ups.  We will recruit approximately 200 dentist practitioners from the six National Dental PBRN regions (Northeast, South Atlantic, South Central, Southwest, Midwest, Western).  Each participating dentist will contribute to a total patient enrollment of approximately 1980. 



The primary objective of this study is to identify the factors that contribute to practitioners’ treatment decisions for patients with painful TMD.

The secondary objectives of this study are to:

  • Identify factors that contribute to patients’ adherence to treatment, and
  • Describe observed changes from baseline at 1-, 3- and 6-month follow-up in pain intensity and jaw function associated with treatments.

The primary outcome measure of this study is the practitioners’ treatment decisions for painful TMD patients. The secondary outcome measures for this study are patient adherence, and pain intensity and jaw function measures. Numerous potential confounders and predictors will be assessed for their associations with the treatment decisions, patient adherence, and changes in pain and function.