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J Am Dent Assoc, Vol 138, No 2, 202-208.
© 2007 American Dental Association

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CLINICAL PRACTICE

Cost-effectiveness of treatments for temporomandibular disorders Biopsychosocial intervention versus treatment as usual



Anna Wright Stowell, PhD, Robert J. Gatchel, PhD and Lynn Wildenstein, MA

Background. The authors conducted a randomized clinical trial to evaluate the cost-effectiveness of a biopsychosocial intervention with patients who are at high risk (HR) of progressing from acute to chronic TMD-related pain.

Methods. The authors classified 96 patients with acute TMD (less than six months’ duration) as HR according to a predictive algorithm and randomized them into an early intervention (EI) or a nonintervention (NI) group. The NI group received a biopsychosocial treatment that included cognitive behavioral skills training and biofeedback. Both groups were followed up for one year. The authors collected TMD cost data throughout the year.

Results. The authors found that the EI group spent significantly fewer jaw-related health care dollars, relative to the NI group, from intake to the one-year follow-up.

Conclusion and Clinical Implications. The reduced jaw-related health care expenditures for patients in the EI group compared with expenditures for patients in the NI group at one year suggest that an early biopsychosocial intervention is a cost-effective measure in dealing with often unnecessarily costly TMD-related pain.

Key Words: Temporomandibular pain; health care costs; conservative treatment; early intervention

Abbreviations: BDI-2: Beck Depression Inventory-2 • CPI: Characteristic Pain Inventory • EI: Early intervention • EOBs: Explanations of benefits • HR: High risk • LOCF: Last-observation-carried-forward • NI: Nonintervention • TMDs: Temporomandibular disorders • WOC: Ways of Coping-Revised




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S. J. Scrivani, D. A. Keith, and L. B. Kaban
Temporomandibular Disorders
N. Engl. J. Med., December 18, 2008; 359(25): 2693 - 2705.
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