Abstract

Objective To gain a deeper understanding of the range of influences on the full range of dental professionals who provide treatment for temporomandibular disorders (TMD).

Design Qualitative semi-structured interviews.

Setting Primary and secondary care in the North and South of the United Kingdom.

Sample and method A criterion-based purposive sample was taken of dental practitioners, comprising primary and secondary care practitioners. In-depth interviews were conducted and data collection and analysis occurred concurrently until data saturation was achieved.

Data and discussion There was a reported lack of adequate remuneration for provision of treatment for TMD within primary care. This alongside the primary care practitioners' reported uncertainty in diagnosis of TMD appeared to lead to a propensity for referral to secondary care. Practitioners recognised a poor and scanty evidence base on which to base their care, and this allowed for idiosyncratic practice. Often the outcome measure for treatment was a subjective questioning of the patient focussing mainly on relief of pain.

Conclusion There is a need for better quality evidence on which to base TMD treatment, more continuing professional development and improvement in contracting arrangements to enable primary practitioners to feel confident in managing TMD.

1. Clinical Fellow, Newcastle University School of Dental Sciences, Framlington Place, Newcastle-upon-Tyne, NE2 4BW;
2. Lecturer in Medical Sociology, Institute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle, NE2 4AA;
3. Consultant/Senior Lecturer, Newcastle University School of Dental Sciences, Framlington Place, Newcastle-upon-Tyne, NE2 4BW
4. Clinical Professor/Consultant, Newcastle University School of Dental Sciences, Framlington Place, Newcastle-upon-Tyne, NE2 4BW

Correspondence to: J. Durham¹ e-mail: J.A.Durham@ncl.ac.uk