Counselling and self‐management therapies for temporomandibular disorders: a systematic review

Abstract

The aim of this review was to investigate the effectiveness of counselling and other self-management-based therapies on muscle and temporomandibular joint (TMJ) pain relief and increasing the functional abilities of patients with temporomandibular disorders (TMD). A systematic literature review was conducted by three independent reviewers and included articles published up to 2012. PubMed and Cochrane Library electronic databases were used in addition to hand-searching to assess clinical outcomes for counselling and self-management approaches for TMD treatment. The review yielded 581 records that were narrowed down to 7. All included studies were classified as blind-randomized controlled clinical trials. The selected articles analysed revealed that counselling was able to improve tenderness upon masticatory muscle palpation and maximum mouth opening with and without pain in patients with TMD, with similar results to those of interocclusal appliances approaches. Thus, counselling- and self-management-based therapies could be considered a conservative low-cost and beneficial treatment alternative for treating TMD to potentially improve psychological domains and remove harmful behaviours for the control of the signs and symptoms of TMD.

Correlation between pressure pain threshold and pain intensity in patients with temporomandibular disorders who are compliant or non-compliant with conservative treatment

“…[5][6][7][8][9][10][11][12][13] Therapeutic modalities include cognitive behavioral therapy, [14][15][16] intra-oral appliances [17][18][19] and therapeutic exercises. 10,20,21 Low-cost therapeutic modalities based on counselling [22][23][24] and selfcare are beneficial and contribute to controlling the signs and symptoms by improving the psychological domains and eliminating deleterious behaviors. 19,22,23,25,26 One of the methods used to assess the effectiveness of any treatment for muscular TMD is to measure the pain that remains post-treatment, and such measurements are usually performed according to visual analogue scales (VAS) or verbal numeric scales.…”

Additional effect of occlusal splints on the improvement of psychological aspects in temporomandibular disorder subjects: A randomized controlled trial

“…14 This influence on higher-order central processing could be related to the improvement of psychological aspects. Furthermore, in a recent systematic review, de Freitas et al 15 stated that counselling and selfmanagement-based therapies could improve psychological aspects and reduce harmful behaviour in TMD subjects. In this scenario, an interesting question arises: considering the potential psychological effects of the occlusal splint, does it have an additional benefit on improving psychological aspects beyond counselling and a self-management strategy?…”

Reduction of head and face pain by challenging lateralization and basic emotions: a proposal for future assessment and rehabilitation strategies

“…In this context, the brain areas and motor neurons are stimulated more strongly than if the motion is solely observed. 54 For patients who experience pain during execution of a movement, imagining the motion decouples it from the pain experience. This specific preparation (explicit imagery) makes the motion subsequently easier and less painful.…”