Tese
Perfil epidemiológico e percepção de usuários sobre o tratamento de disfunção temporomandibular e dor orofacial no centro de especialidades odontológicas do município de Belo Horizonte-Minas Gerais
Fecha
2022-10-26Autor
Patricia Maria da Costa Reis
Institución
Resumen
Orofacial pain (OFP) is all pain associated with soft and mineralized tissues in oral
cavity and face. Usually this pain can be referred to head and neck region or even
associated with other comorbidities. Temporomandibular Disorder (TMD) is a type of
orofacial pain defined as a set of musculoskeletal and neuromuscular conditions
involving masticatory muscles and temporomandibular joint being the most intriguing
problems found in clinical dentistry. It is often chronic or persistent pain, complex and
multifactorial, stressful and disabling so it is important to know epidemiological profile
and perception of patients with TMD-OFP. The aim of this study was to evaluate
epidemiological profile and perception of patients treated in Dental Specialties Center
TMD-OFP of Unified Health System (SUS) in Belo Horizonte (BH), Minas Gerais
(MG) about e experience of using TMD-OFP service and its treatment. To describe
epidemiological profile were evaluated completely filled out medical records
containing RDC/TMD (Research Diagnostic Criteria for Temporomandibular
Disorders) of patients treated in TMD-OFP specialty, from 2015 to 2018, at Dental
Specialty Center (CEO) of Venda Nova region of Belo Horizonte (PBH).
Demographic data, Social Vulnerability Index (IVS) and clinical variables of interest,
such as presence of teeth, comorbidities and painful symptoms were collected. For
perception evaluation about the experience of using the service for
temporomandibular disorders and orofacial pain and its treatment, qualitative
interviews were carried out with a semi-structured script based on the Hellerian
theory in its theoretical framework of everyday life, among volunteers who sought the
CEO to be attended. The interviews were carried out in random individuals attended
at Dental Specialty Center (CEO) of Venda Nova region of Belo Horizonte (PBH),
who were in a previous moment or after the treatment. After that, the qualitative
research narratives were coded and categorized. Descriptive and bivariate analyzes
to describe patients profile treated at Dental Specialty Center (CEO) of Venda Nova
region of Belo Horizonte (PBH) were performed using the chi-square test (P < 0.05).
A sample of 169 patients was included, of which 132 (78.1%) were female, with a
mean age of 43 (± 15.2) years. Patients were referred to the CEO's TMD specialized
service mainly due to pain (40.5%), followed by bruxism (25.6%) and TMJ complaints
(24.4%). Considering pain intensity, 28.4% did not report pain, while 121 (71.6%)
reported pain, with 46.2% mild/moderate pain and 25.4% severe pain. The diagnostic
most find was disc displacement with reduction (DDCR) (30.2%), followed by bruxism
(24.9%). The most indicated treatment was Cognitive Behavioral Therapy (95.3%),
followed by intra-occlusal dispositive (DIO) (54.4%). The presence of pain was more
frequent among female individuals, however, no association was observed between
the occurrence of pain and comorbidities, age and VSI. A total of 13 participants
were evaluated on the perception of experience using the temporomandibular
disorder and orofacial pain service and its treatment, in depth and breadth of
experiences and lived perspectives, where two main themes emerged from data:
Access to specialized service and Perception of treatment. There was no
premeditation of themes and their definitions were in agreement with data analysis. In view of experiences collected and analyzed it is understood that the main point is
little knowledge of TMD specialty by patient and general practitioners, regarding the
difficulties faced in accessing the TMD specialist within the referral system