Five-Year Follow-Up of Patients with Persistent Painful Temporomandibular Disorder After Multidisciplinary Assessment

Abstract

Introduction Painful temporomandibular disorders (pTMD) is a subgroup of TMD, which refers specifically to cases with persistent pain symptoms, often associated with significant functional and psychosocial impact. Purpose To investigate the outcome of patients with persistent pTMD five years after multidisciplinary investigation. Patients and Methods The present study was a five-year follow-up study of 74 patients with pTMD. Baseline data were available for 72 patients. At follow-up, 68 patients were invited to participate, but only 32 responded. A questionnaire equal to the baseline questionnaire, was sent to the patients. It investigated pain duration and pain intensity (General Pain Intensity questionnaire [GPI]), mandibular function (Mandibular Functional Index Questionnaire [MFIQ], two- question Coping Strategies Questionnaire [CSQ]), general health status, psychosocial factors, previous treatments. The follow up included the extent to which they have been followed up by their general medical practitioner (GMP) and whether their TMD symptoms have changed. Results 32 out of 74 patients responded. Pain intensity and pain-related suffering had improved significantly, but mandibular function and restricted jaw movements remained unchanged. Follow-up by general medical practioners was rated poorly. Conclusion Patients who responded to the five-year follow-up reported reduced pain intensity and pain-related suffering compared with baseline, while restricted jaw movements were found to be unchanged. Symptom duration alone showed no clear association with future pain severity and suffering in this sample. Changes in quality of life after multidisciplinary assessment seemed to vary across life domains. Given the low response rate at follow-up, the findings should be interpreted with caution and may not be representative of the entire original cohort.