Temporomandibular joint disorders’ impact on pain, function and disability

University of Minnesota M.S. thesis. Dec 2013. Major: Dentistry. Advisors: Eric Schiffman, Mike John. 1 computer file (PDF); v, 17 pages.Aims: To determine the association between more advanced stages of temporomandibular joint intra-articular disorders (“TMJ intraarticular status”), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability (“TMD impact.”) Methods: This cross-sectional study included 614 cases from the Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intraarticular status was determined by three blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject’s most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of (i) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), (ii) jaw function (Jaw Functional Limitation Scale); and (iii) disability (Disability Points from GCPS). A structural equation model (SEM) estimated the association of TMJ intraarticular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (N=614) and in cases with a TMD pain diagnosis (N=500). Results: The correlations between TMJ intraarticular status and TMD impact were 0.05 (95% CI -0.04 to 0.13) for all TMD cases and 0.07 (95% CI -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conclusion: Conceptualizing worsening of TMJ intra-articular disorders as four stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intraarticular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored

Frequency of four-dimensional oral health problems across dental fields - A comparative survey of Slovenian and international dentists

Objectives: To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. Methods: An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. Results: Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). Conclusion: According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields

Pediatric patients’ reasons for visiting dentists in all WHO regions

Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral healthrelated quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists’ assessment, the study aimed to evaluate whether pediatric dental patients’ oral health concerns ft into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct.Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns ft into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients’ oral health problems and prevention needs were computed

Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.

Objectives To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. Methods An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. Results Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). Conclusion According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields

Why Patients Visit Dentists – A Study in all World Health Organization Regions

The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions