Abstract
The purpose of the present investigation was to identify the most frequent therapies and, in particular, the prescription patterns for occlusal splints for the management of craniomandibular disorders (CMDs) used by German general dentists and specialists. Additionally, the knowledge and opinion of the practising dentists were examined. All active members of the statutory dental insurance providers of the German North Rhine (n = 5,500) and the Westphalia-Lippe area (n = 4,984) were surveyed with a questionnaire by mail. Results indicated that occlusal splints were the first-choice therapy followed by physiotherapy and occlusal equilibration. In the preceding year, both general dentists and specialists made 30 occlusal splints on average. With regard to high-quality evidence-based recommendations, some statistically significant discrepancies between general dentists and specialists were detected. On the basis of the present data, it seems useful to consider intensifying the topic of CMDs and orofacial pain in future undergraduate dental curricula and in postgraduate training.
Similar content being viewed by others
References
Ahlers MO, Freesmeyer WB, Fussnegger M et al (2005) Zur Therapie der funktionellen Erkrankungen des kraniomandibulären Systems. Dtsch Zahnärztl Z 10:539–542
American Academy of Orofacial Pain (1996) Differential diagnosis and management considerations of temporomandibular disorders. In: Okeson JP (ed) Orofacial pain: guidelines for assessment, diagnosis, and management. Quintessence, Chicago, pp 113–184
Ash MM (2007) Occlusion, TMDs, and dental education. Head Face Med 3:1
Baba K, Tsukiyama Y, Clark GT (2000) Reliability, validity, and utility of various occlusal measurement methods and techniques. J Prosthet Dent 83:83–89
Bundeszahnärztekammer (2006) Online Report: Zahnärzte nach Regionen und Geschlecht. http://www.bzaek.de/list/presse/datenfakten/03zaenachregionenugeschlecht.pdf
Clark GT (1984) A critical evaluation of orthopedic interocclusal appliance therapy: design, theory, and overall effectiveness. J Am Dent Assoc 108:359–364
Clark GT, Tsukiyama Y, Baba K et al (1997) The validity and utility of disease detection methods and of occlusal therapy for temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83:101–106
Clark GT, Tsukiyama Y, Baba K et al (1999) Sixty-eight years of experimental occlusal interference studies: what have we learned? J Prosthet Dent 82:704–713
Dao TT, Lavigne GJ (1998) Oral splints: the crutches for temporomandibular disorders and bruxism? Crit Rev Oral Biol Med 9:345–361
De Boever JA, Nilner M, Orthlieb JD et al (2008) Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner. J Orofac Pain 22:268–278
De Laat A (2003) The path from studying masticatory function to managing TMD and pain: a personal journey. J Dent Res 82:8–10
De Laat A, Stappaerts K, Papy S (2003) Counseling and physical therapy as treatment for myofascial pain of the masticatory system. J Orofac Pain 17:42–49
Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6:301–355
Ettlin DA, Mang H, Colombo V et al (2008) Stereometric assessment of TMJ space variation by occlusal splints. J Dent Res 87:877–881
Forssell H, Kalso E, Koskela P et al (1999) Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials. Pain 83:549–560
Freesmeyer WB (1993) Zahnärztliche Funktionstherapie. Hanser, München
Fricton JR (2002) Development of orofacial pain programs in dental schools. J Orofac Pain 16:191–197
Glaros AG, Glass EG, McLaughlin L (1994) Knowledge and beliefs of dentists regarding temporomandibular disorders and chronic pain. J Orofac Pain 8:216–222
Glaros AG, Williams K, Lausten L (2005) The role of parafunctions, emotions and stress in predicting facial pain. J Am Dent Assoc 136:451–458
Glass EG, McGlynn FD, Glaros AG (1991) A survey of treatments for myofascial pain dysfunction. Cranio 9:165–168
Glass EG, Glaros AG, McGlynn FD (1993) Myofascial pain dysfunction: treatments used by ADA members. Cranio 11:25–29
Goulet JP, Clark GT, Flack VF (1993) Reproducibility of examiner performance for muscle and joint palpation in the temporomandibular system following training and calibration. Community Dent Oral Epidemiol 21:72–77
Klasser GD, Greene CS (2009) The changing field of temporomandibular disorders: what dentists need to know. J Can Dent Assoc 75:49–53
Klasser GD, Greene CS (2009) Oral appliances in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:212–223
Laskin D, Greenfield W, Gale E et al (1983) The president's conference on the examination, diagnosis and management of temporomandibular disorders. American Dental Association, Chicago
Le Resche L, Truelove EL, Dworkin SF (1993) Temporomandibular disorders: a survey of dentists' knowledge and beliefs. J Am Dent Assoc 124(90–94):97–106
Mohl ND, Attanasio R (2002) The Third Educational Conference to Develop the Curriculum in Temporomandibular Disorders and Orofacial Pain: introduction. J Orofac Pain 16:173–175
Mongini F, Ciccone G, Ceccarelli M et al (2007) Muscle tenderness in different types of facial pain and its relation to anxiety and depression: a cross-sectional study on 649 patients. Pain 131:106–111
National Institutes of Health Technology (1997) Assessment conference statement: management of temporomandibular disorders, April 29–May 1, 1996. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83:49–50
Naumann M, Lange KP (2003) Opinions and techniques for restoration of endodontically treated teeth. Dtsch Zahnarztl Z 58:280–285
Nilner M, Steenks M, De Boever J et al (2003) Guidelines for curriculum of undergraduate and postgraduate education in orofacial pain and temporomandibular disorders in Europe. J Orofac Pain 17:359–362
Nilner M, Ekberg E, Doepel M et al (2008) Short-term effectiveness of a prefabricated occlusal appliance in patients with myofascial pain. J Orofac Pain 22:209–218
Okeson JP (1987) The effects of hard and soft occlusal splints on nocturnal bruxism. J Am Dent Assoc 114:788–791
Pierce CJ, Weyant RJ, Block HM et al (1995) Dental splint prescription patterns: a survey. J Am Dent Assoc 126:248–254
Rugh JD, Graham GS, Smith JC et al (1989) Effects of canine versus molar occlusal splint guidance on nocturnal bruxism and craniomandibular symptomatology. J Craniomandib Disord 3:203–210
Selaimen CM, Jeronymo JC, Brilhante DP et al (2006) Sleep and depression as risk indicators for temporomandibular disorders in a cross-cultural perspective: a case-control study. Int J Prosthodont 19:154–161
Sessle BJ (2002) Integration of basic sciences into the predoctoral curriculum to study temporomandibular disorders and orofacial pain. J Orofac Pain 16:181–184
Stamm T (2005) Head & Face Medicine—a new journal for 'intra-interdisciplinary' science. Why? When? Where? Head Face Med 1:1
Steenks MH (2007) The gap between dental education and clinical treatment in temporomandibular disorders and orofacial pain. J Oral Rehabil 34:475–477
Tegelberg A, Wenneberg B, List T (2007) General practice dentists' knowledge of temporomandibular disorders in children and adolescents. Eur J Dent Educ 11:216–221
Tekyatan H, Willershausen B, Weißenstein G et al (2004) Questionnaire to concerning presently used concepts for endodontic treatments and subsequent final restorations in German dental offices. Dtsch Zahnarztl Z 59:264–269
Tsukiyama Y, Baba K, Clark GT (2001) An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders. J Prosthet Dent 86:57–66
Turk DC, Zaki HS, Rudy TE (1993) Effects of intraoral appliance and biofeedback/stress management alone and in combination in treating pain and depression in patients with temporomandibular disorders. J Prosthet Dent 70:158–164
Türp JC, Komine F, Hugger A (2004) Efficacy of stabilization splints for the management of patients with masticatory muscle pain: a qualitative systematic review. Clin Oral Investig 8:179–195
Türp JC (2003) Ist die systematische okklusale Einschleiftherapie eine sinnvolle Maßnahme für die Behandlung und Prävention kraniomandibulärer Dysfunktionen? Dtsch Zahnärztl Z 58:612–613
Yap AU, Chua EK, Tan KB et al (2004) Relationships between depression/somatization and self-reports of pain and disability. J Orofac Pain 18:220–225
Acknowledgements
The authors thank the statutory dental insurance providers of the German North Rhine and the Westphalia-Lippe area for their kind support dispatching of the questionnaires. Furthermore, we thank Ms D. Talbot, M.A. for her helpful comments on this paper.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ommerborn, M.A., Kollmann, C., Handschel, J. et al. A survey on German dentists regarding the management of craniomandibular disorders. Clin Oral Invest 14, 137–144 (2010). https://doi.org/10.1007/s00784-009-0282-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00784-009-0282-4