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Perceived helpfulness of treatments for myofascial TMD as a function of comorbid widespread pain



This study examined whether patients with myofascial temporomandibular disorder (mTMD) comorbid with fibromyalgia (FM) receive different treatments or respond differently to these treatments than mTMD-only patients.

Materials and methods

A total of 125 mTMD+ women were enrolled (26 FM+ and 98 FM−). mTMD and FM were assessed via clinical research examinations. Treatment histories and self-reported treatment-related improvement were obtained via interview.


The top 3 most common treatments reported were oral appliances (59%), physical therapy (54%), and jaw exercises at home (34%). Use of alternative medicine was reported more frequently among FM+ women, but self-reported improvement did not differ by comorbid FM. Physical therapy was as likely reported by FM status but self-reported improvement scores trended higher for FM+ women.


Oral appliances were as likely to be reported by FM comorbid as FM− women. Oral appliances did not outperform self-management treatments on self-reported improvement of facial pain.

Clinical relevance

Results support the use of self-management as first-line treatment for mTMD and potential utility of inquiring about widespread pain for treatment planning.

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This work was supported in part by the National Institutes of Health under grants R01DE018569 and R01DE024522-01S1.

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Correspondence to Vivian Santiago.

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The authors declare that they have no conflict of interest.

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This project underwent full ethics review and approval by the New York University School of Medicine Institutional Review Board (IRB#07-303).

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All subjects underwent and signed a full informed consent procedure before enrollment.

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Santiago, V., Raphael, K.G. Perceived helpfulness of treatments for myofascial TMD as a function of comorbid widespread pain. Clin Oral Invest 23, 2929–2939 (2019).

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