Temporomandibular Treatment Outcomes Within Five Diagnostic Categories

ABSTRACT

This study of temporomandibular disorder (TMD) treatment outcomes examines 274 consecutive patients in five diagnostic categories and a 25 patient comparison group to determine relative levels of symptom improvement. Employing a psychometric outcome measure, the TMJ Scale, it was found that patients receiving active TMD treatments manifest statistically significant symptom improvements. Untreated patients reported minor and statistically insignificant symptom variations. Patients with intracapsular TM joint dysfunctions exhibited higher levels of improvement in pain and other TMD symptoms than patients presenting with primarily muscle symptoms. This research supports the hypothesis that TMDs are not self-limiting and require active treatment interventions. It is suggested that some studies cited to show that TMDs are self-limiting have major methodological limitations, relying upon unvalidated and subjective assessments of symptom levels. This research also outlines a procedure for TMD practitioners to measure treatment efficacy and the relative effectiveness of differing treatment modalities in a valid, consistent and unbiased manner.

Additional information

Notes on contributors

Gerald B. Wexler

Dr. Gerald B. Wexler received his B.Sc. and D.D.S. degrees from McGill University, Montreal, Quebec. He has been in private dental practice in Ottawa, Ontario, since 1970, and has been treating temporomandibular joint and orofacial pain problems since 1979. Dr. Wexler is a fellow in the Academy of General Dentistry, a member of the American Equilibration Society, a member of the American Academy of Orofacial Pain, and a member of the American Academy of Head, Neck and Facial Pain. He is on the consulting staff of the Ottawa Civic Hospital Dental Department, where he directed operations at the Temporomandibular Joint Treatment Clinic from 1984 to 1993.

Michael W. McKinney

Dr. Michael W. McKinney received a Master and Ph.D. degrees from the University of Maryland's Division of Behavioral and Social Sciences, College Park, Maryland. He has been a full professor and has taught graduate and undergraduate courses in research methodology and applied statistics at the University of Maryland, Georgia Technical Institute, North Carolina State University, and North Carolina Central University. Dr. McKinney has been a Woodrow Wilson Scholar and a visiting scholar at the University of North Carolina, Chapel Hill He is a co-author of the TMJ Scale and has published many articles in refereed journals in the field of TMD research and psychometric testing. Dr. McKinney's current research interests involve the use of psychometric testing to measure and document TMD treatment outcomes. He serves as a statistical consultant to the American Academy of Head, Neck and Facial Pain's Treatment Outcome project and is currently vice president of Pain Resource Center, Inc.