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The current referral patterns for temporomandibular joint disorders (TMD) in Greater Manchester
R Hamad1, A S E Clark1, I A Pretty2
1Department of Oral Surgery, University Dental Hospital Manchester, M15 6FH, UK.
Insights
Temporomandibular joint disorders (TMD) are common and impact quality of life. Primary care management, with self-care plans and practitioner pathways, is recommended for better patient outcomes and specialist service maintenance.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Public Health
- Rheumatology
Background:
- Temporomandibular joint disorders (TMD) affect a significant portion of the population, impacting quality of life and healthcare costs.
- Chronic TMD presents challenges for patients and health services due to its persistent nature and management expenses.
Purpose of the Study:
- To investigate the incidence of TMD within the Greater Manchester region.
- To identify the most effective healthcare setting for managing TMD patients.
Main Methods:
- Retrospective data collection on patient demographics, symptoms, and treatments for TMD referrals.
- Analysis of 789 referrals to a Tertiary Centre and a District General Hospital (DGH).
Main Results:
- Pain was the most frequent reason for referral (82%), followed by limited jaw opening (55%) and joint sounds (44%).
- Management strategies included splint therapy (27%) and patient advice/leaflets (12%) prior to specialist referral.
Conclusions:
- Reviewing current TMD referral and management practices is crucial due to the impact of chronic pain and associated costs.
- Encouraging timely, conservative TMD management in primary care, supported by self-care plans and practitioner guidelines, can improve patient outcomes and preserve specialist expertise.
Background:
Temporomandibular joint disorders (TMD) affect up to 50% of the population. Chronic TMD may have a significant impact on patients' quality of life and is associated with a significant cost burden to health services.
Aims:
The aim of this study was to investigate the incidence of TMD in Greater Manchester and to determine the most appropriate setting for its management.
Methods:
Data were retrospectively collected on the demographics, symptoms and management provided to patients referred for TMD.
Results:
There were 789 referrals analysed; 616 to a Tertiary Centre and 173 to a District General Hospital (DGH). The most common reason for referral was pain (82%), followed by limitation in opening (55%) and clicks or sounds (44%). 27% of referrals were managed with a splint and 12% were provided with advice or a patient information leaflet prior to referral.
Discussion:
The effect of chronic pain on patients' quality of life and the cost burden of its management compels us to review current practices in referral and management of TMD. Barriers to provision of treatment in primary care may include a lack of training, remuneration or confidence. These may be overcome with the development of self-care plans for patients and a care pathway for practitioners.
Conclusion:
Based on existing evidence, timely and conservative management of TMD should be encouraged in primary care, enabling better outcomes to be achieved for patients and the maintenance of the experience and skill level of specialist services in secondary care.
