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A experiência do doente com DTM e dor orofacial
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Resumo(s)
Este estudo transversal teve como objetivo caracterizar o percurso de pacientes com dor orofacial e/ou disfunção temporomandibular (DTM) até ao diagnóstico, analisando também possíveis diferenças por género. Participaram 131 adultos (idade entre 18 e 80 anos) recrutados em ambientes digitais e académicos. Foram recolhidos dados sociodemográficos do Eixo II do DC/TMD, número de consultas até ao diagnóstico e intensidade/interferência da dor, avaliadas
por escalas numéricas e pela Chronic Pain Grade Scale -Revised (CPGS - R).
Os resultados mostraram que 47,5% dos participantes costumam procuraram diretamente um especialista e 67,9% foram encaminhados por médicos dentistas generalistas (MDG). A maioria recebeu diagnóstico em uma (44,3%) ou duas (30,5%) consultas, sem diferenças significativas entre géneros. A dor atual e máxima teve mediana de 1/10 a 4/10, indicando dor ligeira. Quanto à incapacidade, 85,5% não interromperam atividades nos 30 dias anteriores, predominando os graus I (dor crónica de baixa intensidade e grau de incapacidade nulo), sem disparidades entre géneros.
Apesar dos avanços no diagnóstico precoce com o envolvimento do MDG, persistem lacunas: 12,2% dos pacientes ainda não tinham diagnóstico definitivo e 38,9% estavam em tratamento há mais de um ano. Recomenda-se a adoção de protocolos estandardizados (DC/TMD, ICOP), triagem psicossocial sistemática e atuação de equipas multidisciplinares para melhorar a gestão da dor orofacial crónica e da DTM, além de necessidade de educação contínua de médicos e pacientes sobre dor orofacial e DTM.
This cross-sectional study aimed to characterize the path of patients with orofacial pain and/or temporomandibular dysfunction (TMD) up to diagnosis, also analysing possible differences by gender. A total of 131 adults (from 18 to 80 years old) recruited from digital and academic environments participated. Sociodemographic data from Axis II DC/TMD, referral source, number of consultations until diagnosis and pain intensity/interference, assessed by numerical scales and the Chronic Pain Grade Scale – Revised (CPGS - R), were collected. The results showed that 71.8% of the participants sought a specialist directly and 67.9% were referred by general dentists (MDG). The majority received a diagnosis in one (44.3%) or two (30.5%) consultations, with no significant differences between genders. Current and maximum pain had a median from 1/10 to 4/10, indicating mild pain. Regarding disability, 85.5% had not interrupted activities in the previous 30 days, with grades I, predominating in the CPGS- R (low intensity and no disability), with no disparities between genders. Despite advances in early diagnosis with the involvement of general dentists, gaps persist: 12.2% of patients still did not have a definitive diagnosis and 38.9% had been undergoing treatment for more than a year. The adoption of standardized protocols (DC/TMD, ICOP), systematic psychosocial screening and the action of multidisciplinary teams are recommended to improve the management of chronic orofacial pain and TMD, in addition to the need for continuous education of physicians and patients on orofacial pain and TMD.
This cross-sectional study aimed to characterize the path of patients with orofacial pain and/or temporomandibular dysfunction (TMD) up to diagnosis, also analysing possible differences by gender. A total of 131 adults (from 18 to 80 years old) recruited from digital and academic environments participated. Sociodemographic data from Axis II DC/TMD, referral source, number of consultations until diagnosis and pain intensity/interference, assessed by numerical scales and the Chronic Pain Grade Scale – Revised (CPGS - R), were collected. The results showed that 71.8% of the participants sought a specialist directly and 67.9% were referred by general dentists (MDG). The majority received a diagnosis in one (44.3%) or two (30.5%) consultations, with no significant differences between genders. Current and maximum pain had a median from 1/10 to 4/10, indicating mild pain. Regarding disability, 85.5% had not interrupted activities in the previous 30 days, with grades I, predominating in the CPGS- R (low intensity and no disability), with no disparities between genders. Despite advances in early diagnosis with the involvement of general dentists, gaps persist: 12.2% of patients still did not have a definitive diagnosis and 38.9% had been undergoing treatment for more than a year. The adoption of standardized protocols (DC/TMD, ICOP), systematic psychosocial screening and the action of multidisciplinary teams are recommended to improve the management of chronic orofacial pain and TMD, in addition to the need for continuous education of physicians and patients on orofacial pain and TMD.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Dor orofacial ATM Percurso Dor