| | Pain
Typically, when investigating
TMD as a symptom state, pain reduction is the primary symptom
outcome by which the usefulness of a TMD treatment intervention
will be evaluated. Hence, at the onset, cases selected for inclusion
in such an RCT should enter the study with pain, preferably pain
further operationalized with regard to duration (e.g. pain of
at least three months duration) and intensity (e.g. pain levels
of 3 or greater on a 10-point scale).
However, because TMD
pain is known to fluctuate, evaluating the patient for the presence
of pain may not be so straightforward. For example, asking the
potential study case: "do you have pain in the muscles of
your face, or your jaw joint" may result in a "no"
answer because, at the moment the patient has no pain although
orofacial pain is a characteristic feature of their everyday life.
Thus, the question
about pain should include additional precise operational terms,
such as: …" in the past month, do you have …pain
most of the time…", or "… in the past 2 weeks,
about how many hours of the day have you had pain…".
TMD patients frequently report no pain "right now" when
queried by their dentist even though they consider themselves
burdened with TMD pain problem a great deal of the time.
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