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Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder
Julia Lam1,2,3, Peter Svensson1,4,5, Per Alstergren1,3,6
1Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö, Sweden.
Journal of Medical Internet Research
|October 13, 2020
Summary
An internet-based multimodal pain program showed no significant difference compared to occlusal splint therapy for chronic temporomandibular pain. However, the program improved jaw function, but high attrition rates indicate this pilot study design is not feasible for a larger trial.
Area of Science:
- Oral Medicine
- Pain Management
- Digital Health
Background:
- Chronic pain from temporomandibular disorders (TMD) is undertreated.
- Effective treatment modalities for TMD pain are debated.
Purpose of the Study:
- Investigate the treatment effect of an internet-based multimodal pain program on chronic TMD pain.
- Evaluate the feasibility of a larger randomized controlled trial (RCT).
Main Methods:
- A pilot randomized controlled trial (RCT) with 43 participants with chronic TMD pain.
- Intervention: Dentist-assisted internet-based multimodal pain program (7 modules).
- Control: Conventional occlusal splint therapy. Outcomes assessed at 3 and 6 months.
Main Results:
- High attrition rate: 49% completed 6-month follow-up.
- No significant between-group differences in pain intensity, disability, depression, anxiety, stress, or catastrophizing.
- Internet-based program showed improved jaw function (within-group analysis at 6 months).
- Occlusal splint therapy reduced pain intensity and jaw function limitation.
Conclusions:
- The internet-based multimodal pain program did not show superiority over occlusal splint therapy for chronic TMD pain.
- The program may improve jaw function, and occlusal splints confirmed treatment effects.
- High attrition rates suggest the current RCT design is not feasible for future studies.
