Assessing Treatment Outcomes in Two Temporomandibular Disorder Diagnostic Categories Employing a Validated Psychometric Test
Gerald B. Wexler , B.S.C.,D.D.S.; Michael W. McKinney, M.S.,Ph.D.
ABSTRACT: This study
measures the effects of treatment interventions on two classes of
temporomandibular disorder (TMD) patients in a dental practice in Ottawa,
Canada. Other studies of TMD treatment outcome have employed subjective,
largely qualitative and nonquantitative measures of symptom levels to make
this type of assessment, rendering such research largely incapable of being
replicated. The current study employs the TMJ Scale,™
a validated and psychometrically-developed symptom inventory, to measure
symptom levels before and after treatment. The study first determined the
sensitivity (92.1%) and specificity (88.1%) of the TMJ Scale for 219
patients in the practice population. One hundred and eleven consecutive TMD
patients completed TMJ Scales prior to treatment, and then were retested
after the completion of treatment. Results indicate that patients with
symptoms of internal joint derangement reported more symptomatic improvement
than those with predominantly muscular symptomology, despite the fact that
the latter manifested lower symptom levels initally. Patients with internal
derangement symptoms initally presented with lower levels of psychological
symptoms than patients with muscular symptoms. Substantial improvements in
both groups were noted, employing TMJ Scale percentile rank changes as
outcome measures. This study can serve as a model for future research toward
establishing baselines for expected TMD symptom improvement.
0886-9634/1304-256
The Journal of Craniomandibular Practice Copyright © 1995 by Chroma, Inc.
Manuscript received Dec. 30, 1994; accepted June 20, 1995
Dr. Gerald B. Wexler received
his B.S.C. and D.D.S. degrees from McGill University, Montreal, Quebec. He
has been in private dental practice in Ottawa, Ontario since 1970,and has
been treating temporomandibular joint problems since 1979. He is a fellow in
the Academy of General Dentistry, a member of the American Equilibration
Society, and a member of the American Academy of Orofacial Pain. He is
consulting staff of the Ottawa Civic Hospital Dental Department, where he
directed operation of the Temporomandibular Joint Treatment Clinic from
1984-1993.
Dr. Michael W. McKinney received
M.A. and Ph.D. degrees from the University of Maryland , Division of
Behavioral and Social Sciences, College Park, Maryland. He has been a full
professor of public administration and has taught graduate and undergraduate
courses in social science research methodology and applied statistics at
Georgia Tech University, North Carolina State University, and North Carolina
Central University. Dr. McKinney has been a Woodrow Wilson Scholar and a
visiting scholar at the University of North Carolina in Chapel Hill. He is
codeveloper of the TMJ Scale and is a regular contributor to TMDiary. He is
currently vice president of Pain Resource Center Inc.