Factors Influencing Dental Practitioners in the Management of Temporomandibular Joint Related Disorders in Clinical Practice – A Structural Equation Modelling Approach

Abstract

Background Temporomandibular joint disorders (TMJD) have shown a rising prevalence globally, affecting approximately 31% of adults/elderly and 11% of children/adolescents, with disc displacement with reduction (DDwR) being the most common condition. Despite the significant impact of TMJD on individuals and society, diagnosis and treatment remain inadequate. This study aims to identify factors that are hindering clinicians from managing TMJ-related disorders and to model these factors using latent variable structural equation modeling. Methodology A cross-sectional study was conducted from January to March 2023 among 470 dental practitioners in Chennai, Tamilnadu. The data were collected using a closed-ended questionnaire distributed via Google Forms, achieving an 87% response rate. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to analyze the data, focusing on clinician-related and patient-related factors. Results The measurement model was refined through CFA, achieving acceptable goodness-of-fit measures. The structural model revealed that clinician-related factors significantly impact the decision to manage TMJ disorders (β=0.96), with hesitation due to poor prognosis being the most influential factor. Patient-related factors, though significant, had a lesser impact (β=0.28), with economic affordability being the most influential patient-related factor. Conclusion The decision-making process for managing TMJ disorders is significantly influenced by clinician-related factors, with a lack of knowledge and hesitation due to poor prognosis being major barriers. Thus, enhancing the dental curriculum with comprehensive TMJ management training could improve clinician confidence and patient outcomes. Additionally, addressing patient affordability is crucial for effective treatment planning. This study highlights the need to address knowledge and competency gaps among general dental practitioners and provides insights to inform educational reforms, ultimately improving patient care outcomes.