Efficacy of an early intervention for patients with acute temporomandibular disorder-related pain: A one-year outcome study

Robert Joseph Gatchel, Anna Wright Stowell, Lynn Wildenstein, Richard Riggs, Edward Ellis

Research output: Contribution to journalArticle

84 Scopus citations


Background. The authors conducted a randomized clinical trial to evaluate the efficacy of a biopsychosocial intervention for patients who were at high risk (HR) of progressing from acute to chronic temporomandibular disorder (TMD)-related pain. Methods. The authors classified subjects' risk using a predictive algorithm and randomized them into an early-intervention (EI) or a nonintervention (NI) group. The EI included cognitive behavioral skills training and biofeedback. The authors assessed pain and psychosocial measures at intake and at a one-year follow-up. Subjects' self-reported pain levels were measured on an analog scale and as a response to palpation. Results. At one year, El-group subjects had significantly lower levels of self-reported pain and depression. At one year, more NI-group subjects than El-group subjects had utilized health care for jaw-related pain. NI-group subjects were 12.5 times as likely to have a somatoform disorder, more than seven times as likely to have an anxiety disorder, and 2.7 times more likely to have an affective disorder at one year, compared with EI-group subjects. Conclusions. EI-group subjects had reduced pain levels, improved coping abilities and reduced emotional distress at one year. Clinical Implications. The TMD-related pain experience is complex and requires early identification with a biopsychosoaal EI to achieve maximal, sustainable results.

Original languageEnglish
Pages (from-to)339-347
Number of pages9
JournalJournal of the American Dental Association
Issue number3
Publication statusPublished - 1 Jan 2006



  • Biopsychosocial
  • Early intervention
  • Pain
  • Temporomandibular disorder

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