Abstract
BackgroundThe etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model. However, psychosocial assessment is challenging in daily dental practice. The purpose of the current study was to field-test the practicability of a novel psychosocial assessment scoring form regarding the reliability of scoring procedures and the opinion of examiners. The working hypotheses were that the scoring results of inexperienced undergraduate students were similar to the results collected by a gold standard and that the scoring form was easy to use.MethodsA psychosocial assessment scoring form was developed in accordance with guidelines of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), including results of the Graded Chronic Pain Scale (GCPS), Patient Health Questionnaires (PHQ), and Generalized Anxiety Disorders (GAD). Inexperienced operators (undergraduate students) examined patients with TMD-associated complaints and rated the practicability of the scoring form. The scoring results were recalculated by two experienced operators and a consensus was defined as a gold standard. Reliability coefficients were determined comparing results of the gold standard and the inexperienced operators.ResultsSixty-five examiners used the scoring form to obtain results for patients with TMD-associated complaints. Of the patients, 78.8% received a diagnosis according to DC/TMD decision trees. Two-thirds of the operators (62.9%) stated that the form was easy to complete, and 83.0% would use it in their dental practice. The reliability coefficients ranged between 0.81–1.00.ConclusionsWithin the limitations of the present study, the psychosocial assessment scoring form seems to be an easy-to-use and practicable tool. The vast majority of the inexperienced examiners recommended the application.
Highlights
The etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model
TMD pain is explained by a biopsychosocial model that is strongly influenced by both physical and psychosocial aspects [4]
In patients with TMD, the prevalence of non-specific physical symptoms is estimated to range from 28.5–76.6%, and moderateto-severe levels of depression have a prevalence from 21.4–60.1% [7]
Summary
The etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model. Various research groups demonstrated that non-specific physical symptoms (somatization) and depression play important roles in the etiology and treatment of TMD. In patients with TMD, the prevalence of non-specific physical symptoms is estimated to range from 28.5–76.6%, and moderateto-severe levels of depression have a prevalence from 21.4–60.1% [7]. These comorbidities might have a negative effect on the treatment of TMD [8], while anxiety seems to be a less important factor in the etiology of TMD [9, 10].
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