The implementation of a decision-tree did not increase decision-making in patients with temporomandibular disorders in the public dental health service |
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Authors: | Anna Näsström Jakob Fallgren Anders Wänman Anna Lövgren |
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Affiliation: | 1. Department of Odontology, Faculty of Medicine, Ume? University, Ume?, Swedenanna.lovgren@umu.se;3. Department of Odontology, Faculty of Medicine, Ume? University, Ume?, Sweden |
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Abstract: | Objective: Many patients with temporomandibular disorders (TMD) seem to go undetected within primary dental health care. Primarily we evaluated if the implemented intervention increased the clinical decision-making for TMD patients; secondarily we evaluated if other factors could be identified that predicted performed or recommended TMD treatment.Material and Methods: This case–control study was carried out within the Public Dental Health service in Västerbotten County, Sweden. An intervention based on a decision-tree with three screening questions for TMD (3Q/TMD) was implemented during 2015 in four clinics and compared with the remaining county. A total of 400 individuals were selected—200 3Q-positives and 200 3Q-negatives. The 3Q/TMD consists of Q1—frequent jaw pain, Q2—frequent pain on function, and Q3—frequent catching and/or locking of jaw. The 3Q/TMD answers were analyzed in relation to TMD treatment and any TMD related decision that was collected from the digital dental records.Results: The intervention did not increase the frequencies of traceable clinical decisions among patients with TMD.Conclusions: Despite the implemented intervention aimed, the indicated undertreatment of patients with TMD remains. Future studies are still needed to gain a deeper understanding of the clinical decision-making process for TMD patients in general practice dentistry. |
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Keywords: | Temporomandibular disorders (TMD) orofacial pain health plan implementation clinical decision-making screening |
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