Temporomandibular disorder treatment outcomes: First report of a large-scale prospective clinical study

The diagnosis and treatment of temporomandibular disorders (TMD) has been s urrounded by considerable controversy. Clinical research in the field to da te has been inconsistent and methodologically limited and has not firmly es tablished the role of treatment interventions. This large scale, multisite study attempts to answer some of the questions regarding TMD diagnosis and treatment. More than 6,500 patients are currently being analyzed and 1,212 have completed TMD therapy, providing the basis for comparison with 198 unt reated patients. A wide variety of treatments have been administered from 6 0 practice sites, whose practitioners were carefully calibrated to maximize inter-rater reliability. A validated symptom measurement system, the TMJ S cale, was employed to assure uniform assessment of treatment outcomes. Trea ted patients reported statistically and clinically significant symptom impr ove ment, while untreated patients reported unchanged symptom levels. Data presented here do not support the hypothesis that TMD patients improve spon taneously without treatment.