Patient Education and Self-Management in Adults With Temporomandibular Disorders: Results From a Systematic Review...

To evaluate the efficacy of education and self-management (ED and SM) interventions delivered by a health care provider, either alone or in combination with other non-surgical interventions for improving pain, function, or health-related quality of life (HRQoL) in adults with temporomandibular disorders (TMDs).

Systematic review with meta-analysis.

Six databases were searched up to March 2025.

Randomized clinical trials (RCTs) comparing the efficacy of ED and SM with any non-surgical other interventions such as splints, manual therapy, electrotherapy or multimodal approaches in adults with TMDs. Eligible studies had to report outcomes on pain, function or HRQoL.

Risk of bias was assessed using the Cochrane RoB-1 tool. Pooled treatment effects were calculated using random-effects models with standardized mean differences. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Forty-seven RCTs (n = 3238 participants; 77% female; mean age: 34.4 ± 7.3 years) were included, and none had a low risk of bias. ED and SM interventions were generally delivered as standardized programs and often served as control conditions. Based on very low-certainty evidence, other non-surgical interventions may be more effective than ED and SM alone for short-term pain reduction (SMD = 0.67, 95% CI: 0.13-1.20, 6 studies, 323 patients) or HRQoL improvement (SMD = 0.61, 95% CI: 0.20-1.01, 2 studies, 124 patients). When combined with ED and SM, non-surgical interventions may also result in moderate additional HRQoL improvements (SMD = 0.50, 95% CI: 0.18-0.82, 3 studies, 154 patients). Other comparisons-such as ED and SM alone versus ED and SM combined with other non-surgical interventions-showed comparable effects between groups on pain, function and HRQoL over the short-, medium- and long-term. However, the certainty of evidence supporting these findings remains low to very low.

The certainty of evidence supporting ED and SM interventions for TMDs is very low to low across all outcomes. While some short-term clinically relevant benefits may favour other non-surgical treatments, no consistent superiority or inferiority of ED and SM was found. Combining ED and SM with other interventions did not consistently improve outcomes. High-quality trials are needed to determine the effectiveness of ED and SM and their optimal delivery in TMD care.

CRD42024529862.