Effectiveness of counseling and self-management in patients with temporomandibular disorders: a systematic review

Details

Supervisors

Pitance, Laurent

Faculty

Faculté des sciences de la motricité

Degree label

Master [60] en kinésithérapie et réadaptation

Abstract

Background : Temporomandibular disorders (TMD) are characterized by pain or dysfunction in the jaw joint or associated structures, impacting daily life and often accompanied by psychological symptoms. Risk factors include somatization, mood disorders, parafunctional habits, and stress, with higher prevalence among adults aged 20 to 40 years. Therapeutic approaches vary widely, with physiotherapy, jaw exercises, and manual therapy among the most commonly considered effective. Conservative treatments, including counseling and self-management, are recommended for managing TMD. Counseling and self-management techniques empower patients to manage their symptoms and improve their quality of life. This systematic review aims to provide an updated assessment of the effectiveness of counseling and self-management on patients with TMD suffering from pain or limited jaw function. Methods: A literature search was conducted in four databases by two independent reviewers to identify randomized controlled trials that compared counseling and self-management approach with other types of therapies. Included RCTs were assessed with the Cochrane Risk of Bias tool. Results: 31 randomized controlled trials were included. Two studies favored other therapies over counseling and self-management intervention. In 17 studies, counseling and self-management approaches demonstrated comparable benefits to other types of therapies. four studies indicated greater benefits from counseling and self-management interventions compared to other therapies. Four studies showed the additional benefits of including exercises into counseling and self-management intervention. Lastly, four studies showed that combining counseling and self-management with other therapies led to better improvements compared to these therapies administered alone. Limitations: The diverse interventions and outcome measurements across studies on counseling and self-management present difficulties in assessing their effectiveness. Variability was noted in intervention duration and outcome assessment timing. This heterogeneity complicates direct comparison of the results. A generally moderate methodological quality was noted across the 31 included studies, resulting in an overall uncertain quality of evidence. Conclusions: Counseling and self-management techniques offer benefits for individuals with TMD, in pain relief and jaw function. Combining these approaches with standard treatment shows greater efficacy than standard treatment alone. Including exercises alongside counseling and self-management may further improve outcomes. Standardizing terminology and protocols can enhance future research comparability in TMD management.