• Robert J Gatchel, Anna Wright Stowell, Lynn Wildenstein, Richard Riggs, and Edward Ellis.
• Department of Psychology, College of Science, University of Texas at Arlington, 313 Life Science Building, 501 S. Nedderman Drive, Arlington, Texas 76019-0528, USA. gatchel@uta.edu
• J Am Dent Assoc. 2006 Mar 1;137(3):339-47.

BackgroundThe 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.MethodsThe 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.ResultsAt one year, EI-group subjects had significantly lower levels of self-reported pain and depression. At one year, more NI-group subjects than EI-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.ConclusionsEI-group subjects had reduced pain levels, improved coping abilities and reduced emotional distress at one year.Clinical ImplicationsThe TMD-related pain experience is complex and requires early identification with a biopsychosocial EI to achieve maximal, sustainable results.

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