Students' perceived confidence and challenges to TMD predoctoral education across educational models in U.S. dental...

Predoctoral dental education in temporomandibular disorders (TMD) remains inconsistent and highly variable despite CODA's mandate. This study examined how different TMD educational models (based on orofacial pain [OFP] postgraduate program affiliation, presence of OFP faculty offering TMD patient exposure, or absence of OFP faculty and clinical exposure) influence student confidence and perceived challenges.

An anonymous survey was distributed to third- and fourth-year students at U.S. CODA-accredited dental schools through the Hispanic Student Dental Association and American Student Dental Association. Students rated confidence in TMD-related skills (1-5 scale, 5="most confident") and identified educational challenges. Data were analyzed using ANOVA, chi-square tests, and correlation analyses across four educational models.

Among 136 respondents, overall confidence was low-to-moderate (2.4 ± 0.8), with only 26.3% reaching a sufficient threshold (≥3). Confidence was highest for screening and lowest for advanced procedures. Educational model type showed no significant effect on overall confidence (p = .099), whereas prior TMD patient exposure was associated with higher confidence (2.7 ± 0.7 vs. 2.1 ± 0.7, p < .001; r = .384, p < .001). Common challenges included limited patient availability (61.8%), insufficient faculty expertise (42.3%), and poor interdisciplinary integration (46.3%). Students without OFP faculty and clinical exposure reported significantly greater clinical challenges (p < .001).

Lack of clinical exposure to TMD patients is strongly associated with low student confidence. Faculty calibration and integration of TMD screening and management into routine care are critical to improving competence and confidence in dental training.