| BACKGROUND:Temporomandibular joint and muscle disorders, commonly called "TMD," are a group of conditions that cau se pain and dysfunction in the jaw joint and the muscles that control jaw movement. We don’t know for certain how many people have TMJ disorders. The condition appears to be more common in women than men. For most people, pain in the area of the jaw joint or muscles does not signal a serious problem. Generally, discomfort from these conditions is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Some people, however, develop significant, long-term symptoms.PSYCHOLOGICAL MANAGEMENT IN TEMPOROMANDIBULAR JOINT DISEASEOBJECTIVE:To evaluate the treatment efficacy of psychological management on TMD in comparisionwith traditionalpharmacotherapeutic method.METHODS:A total of50patients were selected.9were excluded for not matching the selection criteria. The rest41patients were randomly assigned to3groups:-as-the Experiment group, the experimentalcontrol group and the Empty control group:-with the case numbers of20,13and8respectively. The participants in the Experiment group were subjected to psychological management only. The participants in the experimental control group were subjected to medication therapy only and those in the empty control group did not receive any treatment. All the pre-treatment indices of the participants were investigated by jaw functions and various scales like VAS, S-TAI and-, SCL-90-.The post-treatment outcomes were evaluated for the corresponding parameters after a period of one month. The changes of the results of S-TAI and SCL90questionnaire were statically examined using one-way ANOVA after the treatment.RESULTS:All the participants in the Experiment group and the Experimental control group had significant improvements in their mouth opening and subjective feeling on VAS scale post-treatmently.The one-way ANOVA analysis was conducted for SAI and TA1separately, and the results showed statistically significant improvement with the p values for SAI and TA1were0.011and0.014respectively. It indicated that the proposed psychological management helped to improve the state as well as the trait anxiety of the participants.The one-way ANOVA analysis was carried out for all the10factors in SCL90separately and an interesting result pattern was indicated. Factor3(interpersonal sensitivity),9(psychoticism) and10(others) did not present significant results with p value of0.09,0.90and0.06 respectively.meaning that interpersonal sensitivity, psychoticism and other factors were not significantly controlled by our treatment modalities.CONCLUSION:Having conducted the study about the Psychological management in TMD, it can be concluded that psychological therapy alone can bring substantial improvement in over all symptoms of the patients, especially in the aspects of mouth opening, pain level, anxiety as well as stress level of the participants postoperatively. The results of S-TAI&SCL90questionnaire proved this result.However similar improvement was also seen in participants of the second group, which were only put on NSAIDs. The over all symptoms of participants in this group also showed improvement according to the above-mentioned scales.It can be suggested that a combination of psychological and pharmacotherapeutical treatment would be a better choice for over all improvement of the patients with TMD.LIMITATONS:Although the utmost care was taken to avoid the drawbacks, the uneven number of participants in each group could still be the limitation of this study. The one month follow up period could be another limitation. |
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