Abstract
We did a clinical service evaluation of patient-reported outcomes for pain and change
in interincisal distance in patients treated with botulinum toxin A (BTX-A) for temporomandibular
myofascial pain at nurse-led clinics. We retrospectively reviewed the clinical records
of 100 patients and the prescribing patterns of two OMFS consultants. The mean starting
pain score of 7.54 out of 10 was reduced by a mean (SD) of 2.48 (2.1) points after
the intervention (p < 0.001). The most common prescription was for 100 units (n = 59 prescriptions). The change in the mean pain scores did not differ significantly
whether 100 or 200 units were prescribed (p = 0.19). Interincisal distance increased by a mean (SD) of 0.5 (5.24) mm after treatment
with BTX-A, which was not significant (p = 0.35). In most cases the treatment helped to manage and reduce the symptoms of temporomandibular
myofascial pain. Considerable improvement in interincisal distance as a result of
this treatment alone, however, is unlikely, but it may have a role in a multifaceted
approach, particularly when other conservative methods have failed. The use of a pro
forma may allow for more consistent record keeping and the detailed assessment of
patient-reported pain scores in the weeks and months after treatment. Development
of an electronic patient-reported outcome (ePRO) tool may facilitate this further.
Keywords
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Article info
Publication history
Published online: December 15, 2019
Accepted:
November 12,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
