Factors associated with clinical decision-making in relation to treatment need for temporomandibular disorders.
OBJECTIVE
The aim of this study was to analyze dentist's clinical decision-making related to treatment need for temporomandibular disorders (TMD) in an adult population.


MATERIALS AND METHODS
The study population comprised 779 randomly selected 35, 50, 65 and 75 year old individuals living in the county of Västerbotten, Sweden. The participants filled out a questionnaire and were examined clinically according to a structured protocol. The four examiners (two men, two women) were experienced dentists and were calibrated before the start of the study. After examination they individually assessed the need of treatment owing to TMD.


RESULTS
In total, 15% of the study population was considered to have a treatment need owing to TMD. The highest estimate was noted for 35 and 50 years old women and the lowest for 65 and 75 years old men. Overall, 21% of the women and 8% of the men were considered to have a treatment need owing to TMD, with statistically significant differences between men and women for the 35 and 50 years old groups. Inter-individual variations in dentists' decisions were observed. In a multivariate analysis, female gender, signs and symptoms of TMD pain, signs and symptoms of TMD dysfunction and smoking were associated with estimated treatment need.


CONCLUSIONS
The prevalence of estimated treatment need owing to TMD was fairly high, but the dentists' clinical decision-making process showed large inter-individual variability. The observation calls for further research on the factors affecting the decision-making process in care providers.
['Yekkalam|Negin|N|', 'Wänman|Anders|A|']
D000328:Adult D000367:Age Factors D000368:Aged D001294:Attitude to Health D002012:Bruxism D000066491:Clinical Decision-Making D003430:Cross-Sectional Studies D003815:Dentists D005157:Facial Pain D005260:Female D006301:Health Services Needs and Demand D006801:Humans D008297:Male D008875:Middle Aged D019558:Occlusal Adjustment D017090:Occlusal Splints D009910:Oral Hygiene D012017:Referral and Consultation D057566:Self Report D012737:Sex Factors D012959:Socioeconomic Factors D013548:Sweden D013705:Temporomandibular Joint Disorders
Clinical decision-making treatment need gender craniomandibular disorder orofacial pain