Painful temporomandibular disorders may soon be better represented in global health metrics following a new consensus-based effort to define the condition for use in Global Burden of Disease estimates.
Although temporomandibular disorders (TMDs) affect approximately one in ten adults and are associated with impaired oral function and reduced quality of life, they are not currently included in Global Burden of Disease measures. A key barrier has been the absence of a standardized lay description required to calculate disability weights.
In a study published in BMC Medicine, researchers developed a proposed lay description through a structured consensus process guided by experts from the Institute for Health Metrics and Evaluation. The process included terminology alignment, workshop-based roundtable discussions, and synthesis of findings.
Participants—including international clinicians, researchers, and patient representatives—were divided into five groups of eight to 12 individuals. They generated 718 descriptive terms, which were refined to 231 unique terms categorized into symptom description, pain location, consequences, and impact.
Researchers reported that no existing lay descriptions adequately captured the characteristics of painful TMDs, and those used for related pain conditions were not sufficiently inclusive.
The final proposed lay description was: “Pain in the jaw, face, cheeks, or around the ears, sometimes radiating to the temples or behind the eyes. The pain may be felt as dull, sharp, tense, or stiff, making chewing, talking, or opening the mouth difficult.”
The group also proposed categorizing TMD severity as mild, moderate, or severe, with pain duration, intensity, and frequency identified as key dimensions linked to severity. Proposed descriptions included:
- Mild: Occasional jaw or facial discomfort that does not interfere substantially with daily activities
- Moderate: Recurring pain that can limit chewing or talking and affect daily activities
- Severe: Persistent pain that makes it difficult to eat, speak, or sleep and greatly affects everyday life
The consensus process did not follow a formal Delphi methodology, and participants may not have fully represented all professions, regions, or cultural perspectives. In addition, discussions were conducted in English, which may have influenced wording and interpretation.
Painful TMDs are also associated with comorbid conditions, including headache and musculoskeletal pain.
Researchers emphasized that accurate lay descriptions are essential for estimating disability weights and that omission of key health impacts may lead to underestimation of disease burden. In prior Global Burden of Disease (GBD) analyses, revising lay descriptions for hearing loss increased the disability weight from 0.093 to 0.316.
“The lay description provides direction on how painful TMDs can be quantified in GBD estimates,” wrote lead study author A. Lövgren, of Umeå University in Sweden, and colleagues.
The researchers noted that this work represents an initial step and that future studies—particularly those incorporating patient perspectives—are needed to ensure alignment with lived experiences.
The researchers reported no competing interests.
Source: BMC Medicine
