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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558


NIETO, María José et al. Referral of patients with temporomandibular joint dysfunction from Primary Care. Rev Esp Cirug Oral y Maxilofac [online]. 2018, vol.40, n.3, pp.112-119. ISSN 2173-9161.


Temporomandibular joint syndrome (TMJS) includes a wide range of signs and symptoms that vary from mild pain in masticatory muscles to inability to open and close the mouth, and even irreversible joint derangement. Management is controversial, with the more acute inflammatory episodes being good candidates for conservative treatment. These patients do not need, at least initially, to be evaluated by a maxillofacial surgeon.

As a maxillofacial referral centre in the Madrid area, it seems that patients affected by this syndrome are referred to our centre from Primary Care on a large scale, and are completely uninformed about their disorder. If this is the case, unnecessary direct and indirect health care costs would be increased, as well as contribute to medical consultation overload.

Material and methods:

A prospective analysis was performed on TMJS patient referral from Primary care to the Hospital Universitario La Paz during a 6 months period. A self-report anonymous questionnaire was also completed by the professional and the patient in order to collect data.


Of the101 patients evaluated, 35.6% had chronic onset (more than 6 months) and with mild symptoms. Almost two-thirds (65.3%) of patients had not received any kind of treatment before coming to the centre. Annual additional costs due to incorrect patient referral were 54,309.024 euros.


Due to its high prevalence, TMJS is an interesting focus for action when it comes to controlling extra costs and medical consultation overload. This report shows the present situation, and stressed the need for a consensus referral protocol in Primary Care.

Keywords : Temporomandibular joint syndrome patients referral; Temporomandibular joint syndrome and economic costs; Temporomandibular joint and economic costs.

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