(88) Interprofessional Care for Temporomandibular Joint Disorders: Psychosocial and Functional Treatment Outcomes

Abstract: Temporomandibular disorders (TMD) refer to debilitating musculoskeletal conditions that affect the temporomandibular joints (TMJ) along with surrounding musculature, and conditions associated with TMD are notoriously difficult to manage. The TMJ Institute at Indiana University School of Dentistry incorporates professionals in the fields of dentistry, medicine, physical therapy, and social work to provide a collaborative approach targeted at improving the physical and psychosocial signs and symptoms of TMD. This multidisciplinary treatment model is not widely practiced due to the logistical challenges of having various disciplines concurrently present in the same clinical space. Patients presenting with complex TMJ dysfunction and psychosocial problems are expected to exhibit decreased feelings of anxiety, depression and pain, in conjunction with an improvement in jaw function following treatment. The aim of this study is to analyze the psychosocial and functional aspects of patients struggling with complex TMD before and after treatment at the TMJ Institute to emphasize the value of treating patients using this interdisciplinary approach. This observational prospective case study began in October 2022 and still currently being conducted. Patients willing to participate in the study are given three questionnaires to complete prior to their first appointment at the TMJ Institute: Hospital Anxiety and Depression (HADS), Graded Chronic Pain Scale (GCPS) and Jaw Functional Limitation Scale (JFLS). The patients then complete the same questionnaires at their follow-up appointment to enable assessment of mean numerical changes. The current sample size includes 64 initial questionnaire submissions and 17 follow-up submissions, which are completed following treatment. Changes in scales are tested for statistical significance using paired t-tests or nonparametric Wilcoxon Signed Rank tests if necessary. Patients presenting with complex TMD have mean parameter post-treatment reductions of -1.30 in jaw function limitation and -1.80 in chronic pain compared to their initial, pre-treatment scores. Although not as noteworthy, patients experienced reductions of -1.15 in depression and -0.54 in anxiety after treatment implementation. The results reinforce the hypothesis that multidisciplinary treatment approaches are effective in treating patients with debilitating TMD.

1. Derwich M, Mitus-Kenig M, Pawlowska E. Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature. Medicina (B Aires). 2020;56(5). doi:10.3390/MEDICINA56050225
2. IUSD TMJ Institute: Dental Professionals: Indiana University School of Dentistry: IUPUI. https://dentistry.iu.edu/professionals/tmj/index.html. Accessed April 5, 2022.
N/AHospital and Depression Anxiety ScaleGraded Chronic Pain ScaleGraph Depicting Initial and Follow-Up Data Values from Study