The Use of Acupuncture in the Treatment of Temporomandibular Dysfunction – An Audit

Abstract

IntroductionThe term temporomandibular dysfunction (TMD) includes a number of painful conditions involving the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. 1 The aetiology of these pain conditions is not clearly understood but appears to be multifactorial and represents an interaction between physical, functional and psychosocial factors. 1 Acupuncture has been used for treatment of TMD and other musculoskeletal pain conditions, and the results of several studies suggest that acupuncture is useful as an adjunct or an alternative treatment of TMD. 2-5The literature regarding the use of acupuncture in the treatment of TMD is, however, limited. AbstractObjective Temporomandibular dysfunction often represents a major therapeutic problem in a dental practice. Evidence from clinical studies suggests that acupuncture may be useful in the treatment of temporomandibular dysfunction. However, most studies have been performed in university settings. The aims of this study were to determine if the results of acupuncture treatment of temporomandibular dysfunction in general dental practice are comparable to the results obtained in previous studies in university clinics, and whether the treatment approach differs from that used in previous studies. Methods The case reports submitted by 15 dentists applying for the diploma of the British Dental Acupuncture Society were combined into one audit. All dentists were informed before submitting the forms that the data might be used for scientific purposes. The criteria for Pain Syndrome Dysfunction were used as inclusion criteria. A visual analogue scale (VAS) was used to assess the pain intensity before and after acupuncture treatment. The acupuncture points and technique used were recorded for each treatment. Results A total number of 70 case reports were received. Ten patients were excluded, as they did not fulfil the criteria. The remaining 60 patients (50 female) fulfilled an average of 3.2 of the Pain Syndrome Dysfunction criteria, out of a possible five. Their mean age was 40.6 years (range 14-68). The average duration of temporomandibular dysfunction was 32 months (range 1-180). The patients received a mean of 3.4 treatments, each treatment lasting on average 12 minutes. The dentists used only manual stimulation, and mainly acupuncture points over the temporomandibular joint and in the masticatory muscles, points on the neck, and additional relaxing points. The mean pain scores were 7.35 (SD 1.52) before treatment and 2.67 (SD 0.58) after treatment (P<0.001). A beneficial effect was observed in 85% with an average reduction in the pain intensity of 75%. Conclusion This audit shows that the results of using acupuncture in the treatment of temporomandibular dysfunction in a general dental practice are comparable to those obtained in clinical studies in university settings. Also the therapeutic approach of using acupuncture is similar. Thus, acupuncture is a simple, relatively safe and potentially efficacious and useful technique in the ma...

Effects of acupuncture in adults with temporomandibular disorders

“…Other successful reports of TMD treatment with acupuncture are described in the literature, with the descriptions of such adopted treatment approaches [12][13][14][15][16] . In a study 8 , authors have shown the negative impact of oral health on the quality of life of individuals with TMD, a therapeutic problem to be also faced by dentists, being acupuncture one indication for therapeutic approach, where from patients who were submitted in average to 3.4 acupuncture sessions, 85% have benefited with pain intensity decrease of approximately 75% 11 , which is very close to the value of our study. Since pain is a frequent reason to look for the health system 6 , it is up to dentists from the health unit to be able to make the differential diagnosis and so choose the therapy, being acupuncture in public services a useful tool for health promotion actions.…”

“…Both pain decrease (pain scale from 5.9 to 1.65) and maintenance of this decrease for at least one year after treatment (pain scale 2.45), were observed in this study, which has evaluated results of acupuncture treatment in adult patients with TMD, results which are similar to a different study 11 where the initial pain scale was 7.35 with decrease after acupuncture treatment to 2.67, without, however, evaluating long term results. Our study has evaluated chronic pain, that is, pain which is not characterized as an alert symptom for the occurrence of body injuries, being difficult to control and major cause of disability, being that TMD has major negative impact on the life of people, especially in the items psychological discomfort and disability 8 .…”

“…This approach broadens the indication of acupuncture to handle TMDs, because it is known that the context to which individuals belong plays a major role in the occurrence of such disorders 1 . TMD signs and symptoms are present in 33.3% of people, with higher prevalence from 21 to 40 years of age 7 , and may even impair quality of life of affected people 8 , so the literature has several studies recommending acupuncture to TMD patients [9][10][11][12][13] ; however, our study has evaluated not only the post-treatment effect but also at least 12 months after treatment completion, in muscle TMD patients.…”

Massage therapy decreases frequency and intensity of symptoms related to temporomandibular joint syndrome in one case study

“…Studies regarding alternative TMJ therapies include acupuncture (List and Helkimo, 1991;McNeely et al, 2006;Rosted et al, 2006;Smith et al, 2006;Wang et al, 1998), chiropractic (Chinappi and Getzoff, 1995;DeVocht et al, 2003), physical therapy (Cleland and Palmer, 2004;Friedman, 1997;McNeely et al, 2006;Michelotti et al, 2005;Sturdivant and Fricton, 2005), relaxation (Wahlund et al, 2003) and meditation (Masarsky, 1983), all of which report varying degrees of success and suggest further investigation. The most widely studied in this review appears to be acupuncture.…”

Acupuncture in the Management of Anxiety Related to Dental Treatment: A Case Series

“…The scale has previously been used in a Danish pilot study concerning the use of acupuncture in dental anxiety. 14 The BAI is a 21-item scale which measures the level of self-reported anxiety. It has demonstrated good convergent and discriminating validity for measuring anxiety levels in clinical and non-clinical populations.…”