The feasibility of a clinical trial of pain related to temporomandibular muscle and joint disorders: the results of a survey from the Collaboration on Networked Dental and Oral Research dental practice-based research networks

J Am Dent Assoc. 2013 Jan;144(1):e1-10. doi: 10.14219/jada.archive.2013.0022.


Background: The authors conducted a survey to characterize the strategies used by general dentists to manage pain related to temporomandibular muscle and joint disorders (TMJDs) and to assess the feasibility of conducting a randomized controlled trial (RCT) to determine the effectiveness of these strategies.

Methods: Dentists from three dental practice-based research networks (PBRNs) (The Dental Practice-Based Research Network, Practitioners Engaged in Applied Research and Learning Network and Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry) agreed to participate in this survey.

Results: Of 862 dentists surveyed, 654 were general dentists who treated TMJDs; among these, 80.3 percent stated they would participate in a future RCT. Dentists treated an average of three patients with TMJD-related pain per month. Splints or mouthguards (97.6 percent), self-care (85.9 percent) and over-the-counter or prescribed medications (84.6 percent) were the treatments most frequently used. The treatments dentists preferred to compare in an RCT were splint or mouthguard therapy (35.8 percent), self-care (27.4 percent) and medication (17.0 percent).

Conclusions: Most general dentists treat TMJD-related pain, and initial reversible care typically is provided. It is feasible to conduct an RCT in a dental PBRN to assess the effectiveness of splint or mouthguard therapy, self-care or medication for the initial management of painful TMJD.

Clinical implications: There is an opportunity to do an RCT in a dental PBRN, which could lead to the development of evidence-based treatment guidelines for the initial treatment of TMJD-related pain by primary care dentists.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Attitude of Health Personnel
  • Community-Based Participatory Research*
  • Dental Research*
  • Dentists / psychology
  • Facial Pain / diagnosis
  • Feasibility Studies
  • Female
  • General Practice, Dental
  • Headache / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Mouth Protectors / statistics & numerical data
  • Nonprescription Drugs / therapeutic use
  • Occlusal Splints / statistics & numerical data
  • Prescription Drugs / therapeutic use
  • Primary Health Care
  • Randomized Controlled Trials as Topic*
  • Scandinavian and Nordic Countries
  • Self Care
  • Surveys and Questionnaires
  • Temporomandibular Joint Disorders / diagnosis
  • Temporomandibular Joint Disorders / drug therapy
  • Temporomandibular Joint Disorders / therapy*
  • Temporomandibular Joint Dysfunction Syndrome / diagnosis
  • Temporomandibular Joint Dysfunction Syndrome / drug therapy
  • Temporomandibular Joint Dysfunction Syndrome / therapy*
  • Treatment Outcome
  • United States


  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antidepressive Agents, Tricyclic
  • Nonprescription Drugs
  • Prescription Drugs