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How dental teams can help patients with temporomandibular disorders receive general dental care: an international Delphi process

Lookup NU author(s): James AllisonORCiD, Dr Elizabeth Offen, Professor Justin DurhamORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background Many patients with temporomandibular disorders (TMD) find it difficult to undergo dental care due to challenges caused by their condition, previous temporomandibular joint surgery or invasive dental procedures, and the impact of comorbid conditions. Managing routine dental care for some patients with TMD can be seen as challenging by some dental practitioners. Objective The objective of this study was to work with patients experiencing TMD and clinicians to co-produce recommendations aimed at helping general dentists to provide routine dental care for patients with TMD. Methods A modified Delphi process was used to co-produce recommendations. Six patients experiencing TMD, patient advocates and seven clinicians took part, including international TMD clinicians. Two meetings were held with patient participants, mediated by a trained facilitator. Recommendations suggested by patient participants were distributed to clinicians who were asked to add additional suggestions, but not to modify patients’ recommendations unless to aid clarity. Additional themes were identified from the existing literature, and the recommendations were then reviewed by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) consortium. Results Recommendations were given to support patients before, during, and after dental treatment. Participants identified specific and practical recommendations to help patients with TMD receive routine dental care, but also emphasised the need for professionals to listen sensitively to patients’ concerns and work with patients in an empathetic and non-judgmental way. Conclusion These recommendations, co-developed with patients experiencing TMD, should help dental professionals to provide supportive general dental care for patients with TMD.

Publication metadata

Author(s): Allison JR, Offen E, Cowley T, Clare D, Bergman S, Ginsburg Feldman J, Schmidt LM, Kalinowski T, Türp JC, Manfredini D, Nixdorf DR, DePalma AMC, Durham J, International Network for Orofacial Pain and Related Disorders Methodology (INfORM)

Publication type: Article

Publication status: Published

Journal: Journal of Oral Rehabilitation

Year: 2023

Volume: 50

Issue: 6

Pages: 482-487

Print publication date: 01/06/2023

Online publication date: 16/03/2023

Acceptance date: 02/03/2023

Date deposited: 24/03/2023

ISSN (print): 0305-182X

ISSN (electronic): 1365-2842

Publisher: Wiley-Blackwell Publishing Ltd


DOI: 10.1111/joor.13444


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