Long-Term Efficacy of Biobehavioral Treatment of Temporomandibular Disorders

Margaret A. Gardea, Robert J. Gatchel, Kiran D. Mishra

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


This study evaluated the relative long-term efficacy of biofeedback, cognitive-behavioral skills training (CBST), combined biofeedback and CBST (Combined), and no-treatment comparison groups in 108 patients suffering from chronic temporomandibular disorder (TMD). After an initial evaluation, patients were assigned to one of the four treatment conditions. The three biobehavioral treatment interventions consisted of 12 standardized sessions. Patients were reevaluated 1 year after completing treatment. Results demonstrated that patients who received the biobehavioral treatments reported significant improvement in subjective pain, pain-related disability, and mandibular functioning 1 year after receiving treatment. The no-treatment comparison group did not demonstrate such improvements. The combined biofeedback and CBST treatment produced the most comprehensive improvements across all outcome measures. These results again demonstrate the heuristic value of adopting a biopsychosocial perspective to the assessment and treatment of chronic medical/dental disorders such as TMD.

Original languageEnglish
Pages (from-to)341-359
Number of pages19
JournalJournal of Behavioral Medicine
Issue number4
StatePublished - Aug 2001


  • Biobehavioral treatment
  • Biofeedback
  • Cognitive-behavioral skills training
  • RDC/TMD diagnosis
  • Temporomandibular disorder


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