Psychological Considerations

Ohrbach, Richard; Michelotti, Ambra

doi:10.1007/978-3-319-19782-1_4

Cited by 6 publications

(24 citation statements)

References 53 publications

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“…Two levels of psychosocial assessment are defined by the DC/TMD (13) and one more was developed in response to specific clinical request (see Table 1 for summary). The brief screening version is intended for research (and clinical) settings where only the briefest biopsychosocial assessment using the fewest number of questions can be incorporated (14). Interestingly, the same components of this brief screening have been informally described by other colleagues, suggesting a convergence into a core minimal set of psychosocial assessment domains.…”

Section: Levels Of Psychosocial Assessmentmentioning

confidence: 99%

International Classification of Orofacial Pain, 1st edition (ICOP)

2020

Cephalalgia

468

201

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Copyright belongs exclusively to the International Headache Society (IHS). The International Classification of Orofacial Pain (ICOP) in this or subsequent editions may be reproduced freely by institutions, societies or individuals for scientific, educational or clinical purposes. Reproduction of any part or parts in any manner for commercial uses requires permission from IHS, which will be granted on payment of a fee.

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Section: Levels Of Psychosocial Assessmentmentioning

confidence: 99%

International Classification of Orofacial Pain, 1st edition (ICOP)

2020

Cephalalgia

468

201

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“…The 11 items independently selected by the Delphi panel for an ultra‐brief screener for non‐specialist care match those selected elsewhere for use with orthodontic patients (e.g. Ohrbach and Michelotti 18 ), attesting to the sensible value of these 11 items in terms of information gained vs patient burden.…”

Section: Resultsmentioning

confidence: 96%

“…17 An ultrabrief screening approach to Axis 2 has also been identified, which captures substantial relevant information coupled with reduced patient and clinician burden. 18 The elements of Axis 2, as well as the three approaches to its use, are demonstrated in Table 1.…”

Section: Introductionmentioning

confidence: 99%

“…For each of the instruments used within these approaches, specific purposes relevant to pain conditions and management have also been described 17 . An ultra‐brief screening approach to Axis 2 has also been identified, which captures substantial relevant information coupled with reduced patient and clinician burden 18 . The elements of Axis 2, as well as the three approaches to its use, are demonstrated in Table 1.…”

Section: Introductionmentioning

confidence: 99%

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Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing

Durham,

Ohrbach,

Baad‐Hansen

et al. 2023

J of Oral Rehabilitation

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BackgroundDespite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non‐specialist settings.ObjectiveTo complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.MethodsAn international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.ResultsWithin the physical axis (Axis 1), the self‐report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10‐section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint‐related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra‐brief 11 item assessment.ConclusionThe bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non‐specialist general dental practice.

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“…INfORM has published guidelines for which Axis‐II instruments should be used at specific levels of care from primary to tertiary; however, no empirical data as yet exist to support the efficacy of these assessment levels to differentiate between simple and complex OFP diagnosis. Moreover, to address barriers to implementation of Axis‐II instruments, an even shorter version of the screener assessment has been proposed for non‐pain specialists, in that an ultra‐brief assessment is better than no assessment, again however without supporting evidence. Such proposals witness how the demands of present clinical practice are outpacing necessary research.…”

Section: Instruments and Constructsmentioning

confidence: 99%

Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain

Sharma

Breckons

Lambelet³

et al. 2019

J of Oral Rehabilitation

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Distress, suffering and care‐seeking behaviour are characteristics of pain‐related disease and illness. Pain that transitions from an acute to a chronic phase carries with it the potential of further effects: these include a worsening of the disease or illness; high‐impact chronic pain; and substantial personal, societal and economic burden. The biopsychosocial model directly addresses these multiple processes, yet clinical frameworks supporting this model are not universally implemented. This paper explores barriers to clinical implementation of a full biopsychosocial framework for temporomandibular disorders (TMD) and other oro‐facial pain (OFP) conditions. In June 2016, INfORM invited OFP researchers to a workshop designed to optimise the DC/TMD Axis‐II. Workshop groups identified five sources of implementation barriers: (1) cultures and societies, (2) levels‐of‐care settings, (3) health services, (4) cross‐cultural validity of self‐report instruments and (5) provider and patient health literacy. Three core problems emerged: (A) mental health aspects are seldom fully considered, thus impairing the recognition of illness, (B) training in use of validated multi‐axial assessment protocols is under‐rated and insufficiently used, and (C) clinical assessment often fails to recognise that sensory and emotional dimensions are fundamental aspects of pain. To improve patient care, these barriers and problems require action. Most importantly, TMD/OFP educators and researchers need to coordinate globally and (i) be educated in the biopsychosocial model, (ii) implement evidence‐based biopsychosocial guidelines for assessment and management of OFP conditions at their institutions, (iii) incorporate this model in undergraduate and postgraduate dental curricula and (iv) be responsive to stakeholders, including regulatory authorities and practitioners.

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Psychological Considerations

Cited by 6 publications

References 53 publications

International Classification of Orofacial Pain, 1st edition (ICOP)

International Classification of Orofacial Pain, 1st edition (ICOP)

Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing

Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain

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