A pilot whole systems clinical trial of traditional Chinese medicine and naturopathic medicine for the treatment of temporomandibular disorders.
OBJECTIVE
To assess the feasibility and acceptability of studying whole systems of Traditional Chinese Medicine (TCM) and Naturopathic medicine (NM) in the treatment of temporomandibular disorders (TMD), and to determine whether there is indication to support further research.


METHODS
A pilot study using a randomized controlled clinical trial design of whole system TCM and NM versus state-of-the-art specialty care (SC).


METHODS
Kaiser Permanente Northwest (KPNW), and practitioner offices in Portland, Oregon.


METHODS
One hundred and sixty (160) women 25-55 years of age attending a KPNW TMD specialty clinic.


METHODS
Whole system TCM and NM, and KPNW TMD clinic SC; the intervention protocols were designed to model the individually tailored type of community care offered in alternative medicine practices in Portland and in the KPNW TMD clinic, using protocols that enhanced similarities among practitioners within each system and permitted full descriptions of the treatments provided.


METHODS
TMD was ascertained using the Research Diagnostic Criteria/TMD; outcomes were self-reported worst and average facial pain and interference with activities (scaled 0-10 where 10 is worst).


RESULTS
Of 948 consecutive eligible patients, 160 were randomized to one of three arms; 128 provided endpoint data. TCM and NM demonstrated significantly greater in-treatment reductions for worst facial pain compared to SC (adjusted regression analysis; higher negative values indicate greater improvement, = -1.11 +/- 0.43, p = 0.010 and -1.02 +/- 0.45, p = 0.025 for TCM and NM, respectively, compared to SC) and at 3 months post-treatment (-1.07 +/- 0.51, p = 0.037 and -1.27 +/- 0.54, p = 0.019 for TCM and NM versus SC, respectively). Additionally, TCM provided significantly greater decreases in average pain than SC; NM provided significantly greater decreases than SC or TCM in TMD-related psychosocial interference.


CONCLUSIONS
These alternative medicine approaches each resulted in significantly greater reduction of pain and psychosocial interference than SC. Further research on the potential benefits of traditional whole systems of medicine for TMD appears warranted.
Ritenbaugh
Cheryl
C
Department of Family and Community Medicine, The University of Arizona, Tucson, AZ 85719, USA. ritenbau@email.arizona.edu
Hammerschlag
Richard
R
Calabrese
Carlo
C
Mist
Scott
S
Aickin
Mikel
M
Sutherland
Elizabeth
E
Leben
Joseph
J
Debar
Lynn
L
Elder
Charles
C
Dworkin
Samuel F
SF
D000203:Activities of Daily Living; D015670:Acupuncture Therapy / Q000379:methods; D000328:Adult; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005157:Facial Pain / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D009324:Naturopathy / Q000379:methods*; D009922:Oregon; D010147:Pain Measurement / Q000379:methods; D010865:Pilot Projects; D012107:Research Design; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
D004365:Drugs, Chinese Herbal