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

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
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Dentist Practice Patterns and Therapeutic Confidence in the Treatment of Pain Related to Temporomandibular Disorders in a Dental Practice-Based Research Network.

Authors

Mayor MeshTerms

Temporomandibular Joint Disorders

Keywords
Journal Title medicine
Publication Year Start




PMID- 29505535
OWN - NLM
STAT- MEDLINE
DCOM- 20180309
LR  - 20180309
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 1
DP  - 2018 Jan
TI  - Dentist's distress in the management of chronic pain control: The example of TMD 
      pain in a dental practice-based research network.
PG  - e9553
LID - 10.1097/MD.0000000000009553 [doi]
AB  - 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.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Yokoyama, Yoko
AU  - Yokoyama Y
AD  - Graduate School of Media and Governance, Keio University, Fujisawa City,
      Kanagawa.
FAU - Kakudate, Naoki
AU  - Kakudate N
AD  - Division of Clinical Epidemiology, Kyushu Dental University, Kitakyushu, Fukuoka,
      Japan.
AD  - University of Florida College of Dentistry, Gainesville, FL.
FAU - Sumida, Futoshi
AU  - Sumida F
AD  - Mikami Dental and Orthodontics Clinic, Tomakomai, Hokkaido.
FAU - Matsumoto, Yuki
AU  - Matsumoto Y
AD  - Matsumoto Dental Clinic, Okazaki, Aichi, Japan.
FAU - Gordan, Valeria V
AU  - Gordan VV
AD  - Department of Restorative Dental Sciences at the University of Florida College of
      Dentistry, Gainesville, FL.
FAU - Gilbert, Gregg H
AU  - Gilbert GH
AD  - Department of Clinical and Community Sciences, School of Dentistry, University of
      Alabama at Birmingham, Birmingham, AL.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Chronic Pain/etiology
MH  - Cross-Sectional Studies
MH  - Dentists/*psychology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Management/*psychology
MH  - Surveys and Questionnaires
MH  - *Temporomandibular Joint Disorders
EDAT- 2018/03/06 06:00
MHDA- 2018/03/10 06:00
CRDT- 2018/03/06 06:00
PHST- 2018/03/06 06:00 [entrez]
PHST- 2018/03/06 06:00 [pubmed]
PHST- 2018/03/10 06:00 [medline]
AID - 10.1097/MD.0000000000009553 [doi]
AID - 00005792-201801050-00032 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Jan;97(1):e9553. doi: 10.1097/MD.0000000000009553.