title: A better definition of counselling strategies is needed to define effectiveness in temporomandibular disorders management.
abstract: METHODS
  The Cochrane Library databases and Medline were searched along with the reference lists of identified articles and The Journal of the American Dental Association, Journal of Orofacial Pain and Journal of Oral Rehabilitation.
  
  
  METHODS
  Controlled clinical trials in which the intervention included the treatment in at least one group with counselling techniques were included. Studies in English, Portuguese or Spanish were considered.
  
  
  METHODS
  A standard data set was retrieved from the articles and a qualitative synthesis was undertaken.
  
  
  RESULTS
  Seven randomised controlled trials involving a total of 489 patients were included. Follow-up periods ranged from four weeks to 12 months. The studies suggested that counselling was able to improve tenderness upon masticatory muscle palpation and maximum mouth opening with and without pain in patients with TMD, with similar results to those of interocclusal appliances approaches.
  
  
  CONCLUSIONS
  Although counselling- and self-management-based therapies could be a conservative low-cost and beneficial treatment alternative for treating TMD, with good results for the relief and control of TMD signs and symptoms by improving psychological domains and potentially reducing harmful behaviours, the evidence remains unclear due to the small number of controlled and randomised well-designed clinical trials. Thus, further studies with higher level of evidence and more representative samples should be conducted to validate the performance of this treatment modality.
authors.affiliation: Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Manfredini
mesh_terms: D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology*; D063806:Myalgia / Q000534:rehabilitation*; D012648:Self Care; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000534:rehabilitation*