Effectiveness of Behavioral and Lifestyle Changes in Reducing TMD Symptoms: Evidence from a Structured Intervention

Objective: To assess the effectiveness of behavioral measures in managing TMDs with an emphasis on pain, joint mobility and psychosocial status. Methods: Forty-eight subjects with TMDs were enrolled based on the RDC/TMD criteria. Stress management, ergonomics training, dietary changes and stretching exercises were recommended as individualized lifestyle plans. The clinical, psychosocial and functional evaluations were done before and after three months of intervention. Results: The frequency of myofascial pain without limited mouth opening was 45. 8% which was reduced to 20. The percentage of subjects with right and left TMJ arthralgia was also seen to have reduced significantly (70. 8% to 43. 7%, p = 0. 0133; 75% to 41. 6%, p = 0. 001). Right TMJ osteoarthrosis and osteoarthritis showed a considerable improvement (p < 0. 05) while the changes in the left TMJ were not significant. Disc displacement with reduction on the right and without reduction on the left side was also found to have improved markedly (p = 0. 036; p = 0. 041). Depression severity was also found to have reduced significantly with the normal levels increasing from 45. 8% to 83. 3% (p < 0. 05). Pain intensity as measured by VAS also reduced from 4. 72 ± 1. 44 to 3. 43 ± 1. 38 (p = 0. 001). There was also an enhancement in the non-specific physical symptoms but the differences were not statistically significant. Conclusions: The present study demonstrated that the implementation of lifestyle modifications helps in decreasing the symptoms of TMD, increases the joint function and has a positive effect on the psychosocial status of the patients and therefore should be considered as the first-line treatment in the management of TMD.