Abstract

Personalized and Patient-Centered Approach to TMD patients

by Michelotti Ambra

Temporomandibular disorders (TMD) encompass a heterogeneous group of conditions affecting the temporomandibular joint, masticatory muscles, and associated structures, often presenting with pain, dysfunction, and significant psychosocial impact. Given the multifactorial etiology and variability in clinical presentation, a one-size-fits-all treatment approach is increasingly recognized as inadequate. This lecture will explore the importance of a personalized and patient-centered model in the diagnosis and management of TMD patients. Personalized care integrates clinical findings with individual patient characteristics—such as genetic predisposition, pain sensitivity, psychological status, and lifestyle factors—while a patient-centered approach emphasizes active patient participation, shared decision-making, and respect for patient values and preferences. An important consideration emerging from patient-centered evaluations is the potential presence of body dysmorphic disorder (BDD) in a minority of patients. This aspects is a link between temporomandibular disorders and orthodontic treatment. Individuals with BDD may exhibit persistent dissatisfaction with their appearance despite objectively successful treatment. In such cases, orthodontic care alone may not address underlying psychological concerns. These findings emphasize the importance of early identification of unrealistic expectations and possible indicators of BDD, as well as the value of multidisciplinary collaboration when appropriate. Emerging evidence supports that tailored interventions, including behavioral therapy, physical therapy, pharmacological management, and occlusal appliances, when guided by a personalized framework, can improve clinical outcomes and patient satisfaction. This approach aligns with the principles of precision medicine and reflects a paradigm shift from symptom-based treatment to holistic care strategies, fostering better long-term management of TMD.

Learning Objectives

After this lecture, you will be able to understand the multifactorial etiology and the variability in the clinical presentation of temporomandibular disorders.
After this lecture, you will be able to understand the importance of personalized care that integrates clinical findings with the individual characteristics of the patient, while a patient-centered approach emphasizes active patient participation, shared decision-making, and respect for the patient's values and preferences.
After this lecture, you will be able to apply a patient-centered approach that emphasizes active patient participation, shared decision-making, and respect for the patient's values and preferences.