Patterns of dental care utilization among patients with temporomandibular disorders

To use data from a large health maintenance organization to specifically investigate dental utilization rates among patients with and without temporomandibular disorders (TMD).

Subjects were enrolled in Kaiser Permanente Northwest between 1998 and 2003. Two age- and gender-matched controls were selected for each subject who had a TMD diagnosis during the study period. Dental treatment was categorized using Current Dental Terminology (CDT) codes. Overall dental utilization rates were calculated, as well as rates based on age, gender, categories of treatment, and periods before and after TMD diagnoses. These rates were analyzed with t tests.

TMD subjects utilized significantly more dental services than comparison subjects overall and for several dental categories. The difference was between 10% to 20%, or about 1 additional dental procedure per year. A positive linear relationship existed between dental utilization rates and age, with a significant increase in utilization for each ascending age cohort. Females had higher dental utilization rates than males in TMD and non-TMD groups and in all categories of dentistry. After a TMD diagnosis, major differences in utilization were not found when compared to patterns of treatment prior to the diagnosis.

TMD subjects utilized 10% to 20% more dental services than non-TMD subjects. Gender and age were important factors with increased utilization in females and older patients. TMD diagnoses did not affect dental utilization patterns, indicating that most TMD patients continue to seek routine dental care.