Perfil epidemiológico e percepção de usuários sobre o tratamento de disfunção temporomandibular e dor orofacial no centro de especialidades odontológicas do município de Belo Horizonte-Minas Gerais

Abstract

Orofacial pain (OFP) is all pain associated with soft and mineralized tissues in oral cavity and face. Usually this pain can be referred to head and neck region or even associated with other comorbidities. Temporomandibular Disorder (TMD) is a type of orofacial pain defined as a set of musculoskeletal and neuromuscular conditions involving masticatory muscles and temporomandibular joint being the most intriguing problems found in clinical dentistry. It is often chronic or persistent pain, complex and multifactorial, stressful and disabling so it is important to know epidemiological profile and perception of patients with TMD-OFP. The aim of this study was to evaluate epidemiological profile and perception of patients treated in Dental Specialties Center TMD-OFP of Unified Health System (SUS) in Belo Horizonte (BH), Minas Gerais (MG) about e experience of using TMD-OFP service and its treatment. To describe epidemiological profile were evaluated completely filled out medical records containing RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders) of patients treated in TMD-OFP specialty, from 2015 to 2018, at Dental Specialty Center (CEO) of Venda Nova region of Belo Horizonte (PBH). Demographic data, Social Vulnerability Index (IVS) and clinical variables of interest, such as presence of teeth, comorbidities and painful symptoms were collected. For perception evaluation about the experience of using the service for temporomandibular disorders and orofacial pain and its treatment, qualitative interviews were carried out with a semi-structured script based on the Hellerian theory in its theoretical framework of everyday life, among volunteers who sought the CEO to be attended. The interviews were carried out in random individuals attended at Dental Specialty Center (CEO) of Venda Nova region of Belo Horizonte (PBH), who were in a previous moment or after the treatment. After that, the qualitative research narratives were coded and categorized. Descriptive and bivariate analyzes to describe patients profile treated at Dental Specialty Center (CEO) of Venda Nova region of Belo Horizonte (PBH) were performed using the chi-square test (P < 0.05). A sample of 169 patients was included, of which 132 (78.1%) were female, with a mean age of 43 (± 15.2) years. Patients were referred to the CEO's TMD specialized service mainly due to pain (40.5%), followed by bruxism (25.6%) and TMJ complaints (24.4%). Considering pain intensity, 28.4% did not report pain, while 121 (71.6%) reported pain, with 46.2% mild/moderate pain and 25.4% severe pain. The diagnostic most find was disc displacement with reduction (DDCR) (30.2%), followed by bruxism (24.9%). The most indicated treatment was Cognitive Behavioral Therapy (95.3%), followed by intra-occlusal dispositive (DIO) (54.4%). The presence of pain was more frequent among female individuals, however, no association was observed between the occurrence of pain and comorbidities, age and VSI. A total of 13 participants were evaluated on the perception of experience using the temporomandibular disorder and orofacial pain service and its treatment, in depth and breadth of experiences and lived perspectives, where two main themes emerged from data: Access to specialized service and Perception of treatment. There was no premeditation of themes and their definitions were in agreement with data analysis. In view of experiences collected and analyzed it is understood that the main point is little knowledge of TMD specialty by patient and general practitioners, regarding the difficulties faced in accessing the TMD specialist within the referral system