Why Seek Treatment for Temporomandibular Disorder Pain Complaints? A Study Based on Semi-structured Interviews

Aims: To identify potential predictors of self-reported sleep bruxism (SB) within children's family and school environments. Methods: A Aims: To assess possible differences between care seekers and non-care seekers with temporomandibular disorder (TMD) pain complaints, by using semi-structured interviews. Methods: Semi-structured interviews were held with 16 subjects who had TMD- pain complaints: 8 care seekers and 8 non-care seekers, matched for age, sex, pain intensity, and fear of movement. Subjects were selected from a previously held survey study, with their consent. The interviews were audiotaped, transcribed verbatim, and analyzed according to qualitative content analysis. Results: From the analysis, seven themes differentiating care seekers from non-care seekers were identified: catastrophizing, pain management, assertiveness, critical attitude towards health care, confidence in medical care, recognition, and adequate referral. Conclusion: Aspects upon which care seekers differed from non-care seekers were mainly person-related characteristics. Next to these characteristics, it appeared that inadequate referrals may play a role in care seeking. The use of semi-structured interviews may further improve insights into processes that determine care seeking among people with TMD pain complaints.

care seeking; health care practitioners; qualitative research; semi-structured interviews; temporodisorder pain

1. Macfarlane TV, Blinkhorn aS, Davies rM, Kincey J, Worthington HV. Oro-facial pain in the community: Prevalence and associated impact. community Dent Oral Epidemiol 2002 feb;30:52–60.

2. Sessle BJ, Lavigne GJ, Lund JP, Dubner r (eds). Orofacial Pain: from Basic Science to clinical Management, ed 2. chicago: Quintessence, 2008.

3. fillingim rB, Wallace Mr, Herbstman DM, ribeiro-Dasilva M, Staud r. Genetic contributions to pain: a review of findings in humans. Oral Dis 2008;14:673–682.

4. Locker D. The symptom iceberg in dentistry. Treatment-seeking in relation to oral and facial pain. J can Dent assoc 1988;54:271–274.

5. Macfarlane TV, Kincey J, Worthington HV. The association between psychological factors and oro-facial pain: a community-based study. Eur J Pain 2002;6:427–434.

6. Macfarlane TV, Blinkhorn aS, Davies rM, Kincey J, Worthington HV. factors associated with health care seeking behaviour for orofacial pain in the general population. community Dent Health 2003;20:20–26.

7. rollman a, Visscher cM, Gorter rc, naeije M. care seeking for orofacial pain. J Orofac Pain 2012;26:206–214.

8. Diatchenko L, nackley aG, Slade GD, fillingim rB, Maixner W. idiopathic pain disorders—Pathways of vulner-ability. Pain 2006;123:226–230.

9. Plesh O, Wolfe f, Lane n. The relationship between fibromyalgia and temporomandibular disorders: Prevalence and symptom severity. J rheumatol 1996;23:1948–1952.

10. Dworkin Sf. Perspectives on the interaction of biological, psychological and social factors in TMD. J am Dent assoc 1994;125:856–863.

11. ferreira M, Machado G, Latimer J, Maher c. factors defining care-seeking in low back pain—a meta-analysis of population based surveys. Eur J Pain 2010;14:747.e1–747.e7.

12. Mortimer M, ahlberg G. To seek or not to seek? care-seeking behaviour among people with low-back pain. Scand J Public Health 2003;31:194–203.

13. campbell SM, roland MO. Why do people consult the doctor? fam Pract 1996;13:75–83.

14. Pope c, Mays n. reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ 1995 Jul 1;311(6996):42–45.

15. forman J, creswell JW, Damschroder L, Kowalski cP, Krein SL. Qualitative research methods: Key features and insights gained from use in infection prevention research. am J infect control 2008;36:764–771.

16. Dworkin Sf, Leresche L. research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J craniomandib Disord 1992;6:301–355.

17. Kvale S (ed). interViews: an introduction to Qualtitative research interviewing. Thousand Oaks, ca: Sage, 1996.

18. Durham J, Steele JG, Wassell rW, Exley c. Living with uncertainty: Temporomandibular disorders. J Dent res 2010; 89:827–830.

19. Glaser BG. The constant comparative method of qualitative analysis. Soc Probl 1965;12:436–445.

20. fink a, Kosecoff J, chassin M, Brook rH. consensus methods: characteristics and guidelines for use. am J Public Health 1984;74:979–983.

21. Jones J, Hunter D. consensus methods for medical and health services research. BMJ 1995 aug 5;311(7001):376–380.

22. Durham J, Steele J, Moufti Ma, Wassell r, robinson P, Exley

c. Temporomandibular disorder patients’ journey through care. community Dent Oral Epidemiol 2011;39:532–541.

23. Wolf E, Birgerstam P, nilner M, Petersson K. nonspecific chronic orofacial pain: Studying patient experiences and perspectives with a qualitative approach. J Orofac Pain 2008; 22:349–358.

24. Edmunds S, Brown G. Doing qualitative research in dentistry and dental education. Eur J Dent Educ 2012;16:110–117.

25. Vlaeyen JW, Linton SJ. fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000; 85:317–332.

26. Gatchel rJ, Stowell aW, Wildenstein L, riggs r, Ellis E 3rd. Efficacy of an early intervention for patients with acute temporomandibular disorder-related pain: a one-year outcome study. J am Dent assoc 2006;137:339–347.

27. fox S. Health information is a popular pursuit online. 2011. http://www.sahs.uth.tmc.edu/evbernstam/Hi6308_Materials/PiP_Health_report.pdf {accessed 19 June 2013].

28. fricton Jr. Development of orofacial pain programs in dental schools. J Orofac Pain 2002;16:191–197.

29. nilner M. curriculum guidelines for orofacial pain and temporomandibular disorders. European academy of cranio- mandibular Disorders. Eur J Dent Educ 2001;5:136–138.

30. Lobbezoo f, van der Zaag J, Visscher cM, naeije M. Oral kinesiology. a new postgraduate programme in the netherlands. J Oral rehabil 2004;31:192–198.