Format

Send to

Choose Destination
Medicine (Baltimore). 2018 Jan;97(1):e9553. doi: 10.1097/MD.0000000000009553.

Dentist's distress in the management of chronic pain control: The example of TMD pain in a dental practice-based research network.

Author information

1
Graduate School of Media and Governance, Keio University, Fujisawa City, Kanagawa.
2
Division of Clinical Epidemiology, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
3
University of Florida College of Dentistry, Gainesville, FL.
4
Mikami Dental and Orthodontics Clinic, Tomakomai, Hokkaido.
5
Matsumoto Dental Clinic, Okazaki, Aichi, Japan.
6
Department of Restorative Dental Sciences at the University of Florida College of Dentistry, Gainesville, FL.
7
Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL.

Abstract

We aimed to obtain greater understanding of dentists' distress when they diagnose and treat patients with temporomandibular disorders (TMD), and to explore ways in which TMD can be better treated.We conducted a cross-sectional study based on a questionnaire survey of dentists (n = 148). Dentists were queried using an open-ended questionnaire about distress they experienced when treating patients with TMD. Survey responses were analyzed using mixed methods. Associations between specific dentist and patient characteristics and types of distress were analyzed by one way analysis of variance and residual analysis.One hundred thirteen clinicians responded to the questionnaire, giving a 76% response rate. Thematic analysis identified 6 major themes: difficulty in predicting therapeutic effect and prognosis; difficulty in diagnosis; difficulty in the decision about whether to do occlusal adjustment; difficulty in specifying a cause; difficulty in communicating with patients and mental factors; and health insurance system barriers. Clinicians who reported difficulty in deciding whether to do occlusal adjustment saw significantly more patients who experienced shoulder stiffness and headache (P = .008 and P = .022, respectively). Dentists' knowledge of TMD guidelines was associated with a lower percentage of difficulty in predicting therapeutic effect and prognosis (residual analysis; P = .010).These findings provide important insights into clinician's perception of difficulties with patients experiencing TMD-related pain. Knowledge of the existence of TMD clinical practice guidelines may lower dentist distress, particularly with regard to prognosis. Further studies are needed to decrease dentist's distress and to overcome the evidence-practice gap in TMD treatment.

PMID:
29505535
PMCID:
PMC5943127
DOI:
10.1097/MD.0000000000009553
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wolters Kluwer Icon for PubMed Central
Loading ...
Support Center