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Filling in the Gaps. Making sense of living with temporomandibular disorders: a reflexive thematic analysis.

Lookup NU author(s): Dr Chris PenlingtonORCiD, Professor Justin DurhamORCiD, Dr Rachel GreenORCiD



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


Introduction Persistent, painful temporomandibular disorders (TMD) are challenging to manage and usually require the active engagement of patients. To achieve this, it is necessary to understand the complex and multifactorial nature of persistent pain. Many dental professionals have little education about persistent pain and may prefer to offer structural management and advice. This research aims to explore how people understand their persistent TMD and how this understanding has been influenced by their treatment providers. Methods Twenty-one people were recruited to represent a diversity of experience with persistent TMD. Interviews followed a semi-structured topic guide. Themes were constructed through reflexive thematic analysis to represent how people made sense of their symptoms and the messages that they had picked up through their treatment journey. Results Participants described examples of conflicting opinions and inconsistent management recommendations. They rarely recalled collaborative discussions about the nature and complexity of their symptoms and different options for treatment. This experience is represented by a single theme, “a medical merry-go-round”. Sub-themes of “a medical journey to nowhere – participants’ frustrated attempts to find medical management that will end their pain” and “is it me? – participants’ questioning their role in persisting pain” kept participants on the merry-go-round, while symptom resolution and participants’ emerging development of a holistic understanding of their TMD pain provided exit points. Understanding pain holistically tended to be helpful and typically occurred despite rather than because of the advice given in routine treatment settings. Conclusion Participants in this study had not typically found their pain management within dental and medical settings to have helped them to construct meaning and understand their experiences of painful TMD. However, understanding symptoms holistically was experienced as beneficial. This study suggests that improved communication and signposting within services for persistent TMD may be beneficial to patients suffering from TMD pain.

Publication metadata

Author(s): Penlington C, Durham J, O'Brien N, Green R

Publication type: Article

Publication status: Published

Journal: Journal of Dental Research Clinical and Transational Research

Year: 2024

Pages: EPub ahead of Print

Online publication date: 03/01/2024

Acceptance date: 09/11/2023

Date deposited: 09/11/2023

ISSN (print): 2380-0844

ISSN (electronic): 2380-0852

Publisher: Sage Publications, Inc.


DOI: 10.1177/23800844231216652


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Funder referenceFunder name
Wellcome Trust Small Grant Scheme through Newcastle University