CHRONIC ILLNESS OF THE TEMPOROMANDIBULAR JOINTS AS EXPERIENCED BY SUPPORT-GROUP MEMBERS

Purpose: For temporomandibular disorders, the clinical situation is on e of considerable etiologic, diagnostic, and therapeutic uncertainty. Using interview data, this report describes this condition and the sea rch for care from the perspective of sufferers who are support-group m embers. Participants and methods: Thirty-two individuals participated; all were members of a support group for individuals with long-term pr oblems attributed to the temporomandibular joints and/or the surroundi ng masticatory muscles. Using a structured, open-ended interview forma t, this study investigated how individuals understand and give meaning to their symptoms, their patterns of care seeking, and the consequenc es of the illness on their lives. The participants also completed seve ral structured questionnaires. Results: For these support-group member s, symptoms extended beyond the jaw and surrounding area, with extensi ve musculoskeletal involvement and resulting dysfunctions that have fa r-reaching consequences for the sufferers' lives. Primary care physici ans are often consulted, especially early in the illness history. They also provide ongoing care and are asked for guidance when patients se ek specialized treatment. A striking aspect of the findings from the i nterviews is the complex and costly pattern of health care seeking. Th is extended search for effective treatment is examined with reference to culturally based understandings, shared by patients and clinicians, about the nature of illness.