Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study

Erik Lindfors; Taro Arima; Lene Baad-Hansen; Merete Bakke; Antoon De Laat; Nikolaos Nikitas Giannakopoulos; Alan Glaros; Antonio Sergio Guimaraea; Anders Johansson; Yrsa Le Bell; Frank Lobbezoo; Ambra Michelotti; Frauke  Müller; Richard Orbach; Anders Wänman; Tomas Magnusson; Malin Ernberg

doi:10.11607/ofph.2359

Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study

Erik Lindfors, Taro Arima, Lene Baad-Hansen, Merete Bakke, Antoon De Laat, Nikolaos Nikitas Giannakopoulos, Alan Glaros, Antonio Sergio Guimaraea, Anders Johansson, Yrsa Le Bell, Frank Lobbezoo, Ambra Michelotti, Frauke Müller, Richard Orbach, Anders Wänman, Tomas Magnusson, Malin Ernberg

Section 01 - Prosthetics

Abstract

Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises. Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from "strongly agree" to "strongly disagree." The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts' earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement. Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality. Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.

Original language	English
Journal	Journal of Oral & Facial Pain and Headache
Volume	33
Issue number	4
Pages (from-to)	389-398
ISSN	2333-0384
DOIs	https://doi.org/10.11607/ofph.2359
Publication status	Published - 2019

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Lindfors, E., Arima, T., Baad-Hansen, L., Bakke, M., De Laat, A., Giannakopoulos, N. N., Glaros, A., Guimaraea, A. S., Johansson, A., Le Bell, Y., Lobbezoo, F., Michelotti, A., Müller, F., Orbach, R., Wänman, A., Magnusson, T., & Ernberg, M. (2019). Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study. Journal of Oral & Facial Pain and Headache, 33(4), 389-398. https://doi.org/10.11607/ofph.2359

Lindfors, E, Arima, T, Baad-Hansen, L, Bakke, M, De Laat, A, Giannakopoulos, NN, Glaros, A, Guimaraea, AS, Johansson, A, Le Bell, Y, Lobbezoo, F, Michelotti, A, Müller, F, Orbach, R, Wänman, A, Magnusson, T & Ernberg, M 2019, 'Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study', Journal of Oral & Facial Pain and Headache, vol. 33, no. 4, pp. 389-398. https://doi.org/10.11607/ofph.2359

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title = "Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study",

abstract = "Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises. Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from {"}strongly agree{"} to {"}strongly disagree.{"} The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts' earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement. Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality. Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.",

author = "Erik Lindfors and Taro Arima and Lene Baad-Hansen and Merete Bakke and {De Laat}, Antoon and Giannakopoulos, {Nikolaos Nikitas} and Alan Glaros and Guimaraea, {Antonio Sergio} and Anders Johansson and {Le Bell}, Yrsa and Frank Lobbezoo and Ambra Michelotti and Frauke M{\"u}ller and Richard Orbach and Anders W{\"a}nman and Tomas Magnusson and Malin Ernberg",

year = "2019",

doi = "10.11607/ofph.2359",

language = "English",

volume = "33",

pages = "389--398",

journal = "Journal of Oral & Facial Pain and Headache",

issn = "2333-0384",

publisher = "Quintessence Publishing",

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T1 - Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study

AU - Lindfors, Erik

AU - Arima, Taro

AU - Baad-Hansen, Lene

AU - Bakke, Merete

AU - De Laat, Antoon

AU - Giannakopoulos, Nikolaos Nikitas

AU - Glaros, Alan

AU - Guimaraea, Antonio Sergio

AU - Johansson, Anders

AU - Le Bell, Yrsa

AU - Lobbezoo, Frank

AU - Michelotti, Ambra

AU - Müller, Frauke

AU - Orbach, Richard

AU - Wänman, Anders

AU - Magnusson, Tomas

AU - Ernberg, Malin

PY - 2019

Y1 - 2019

N2 - Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises. Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from "strongly agree" to "strongly disagree." The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts' earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement. Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality. Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.

AB - Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises. Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from "strongly agree" to "strongly disagree." The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts' earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement. Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality. Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.

U2 - 10.11607/ofph.2359

DO - 10.11607/ofph.2359

M3 - Journal article

C2 - 31247061

SN - 2333-0384

VL - 33

SP - 389

EP - 398

JO - Journal of Oral & Facial Pain and Headache

JF - Journal of Oral & Facial Pain and Headache

IS - 4

ER -

Jaw exercises in the treatment of temporomandibular disorders – an international modified Delphi study

Abstract

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