Resumen de Reasons that patients do not return for appointments in the initial phase of treatment of temporomandibular disorders

DeBoever Appelgren, Katrien van Wormhoudt, Erika DeBoever

• Patients suffering from pain and dysfunction in the temporomandibular region sometimes ignore appointments after the initial examination. This form ofnoncompliance is well known and is often studied in patients suffering from recurrent headaches, arthritis, and lower back pain. Information on patients with temporomandibulr disorders (TMD) who fail to attend the next visits and do not comply with the proposed treatment is scarce. To 61 patients (aged 20 - 40 years) who did not attend the next visit after an initial examination and after discussing the treatment protocol, a questionnaire was mailed 6 monthes to 1 year after the first visit. The uestions related to reasons for not attending nd the possible treatment received. Some questions were also related to the present TMD stte. The clinical profiles of the nonattenders were compared to those of a group of 400 TMD patients who did finish the proposed treatment (positive control). The nonattenders had more pain and dysfunction at initial examination than did the treated patients. The treated patients reported a shorter duration of symptoms before seeking treatment than did the nonattenders, suggesting tht the latter group had a more chronic pain state. The main reason for no returning was that symptoms improved enough or disappeared completely and spontaneously without the proposed treatment. Sixteen patients did not return for further treatment for reasons linked to the dentist-patient relationship. Fifty-seven percent of the nonattenders reported to be symptom free or sufficiently improved. One year after the initial examination and without the proposed treatment, most still had some symptoms such as clicking (59%) and reduced opening (21%) but only 24% reported to be in need of treatment.