{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:24:27Z","timestamp":1783124667021,"version":"3.54.6"},"reference-count":39,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["Small Grant Scheme \/ Newcastle University"],"award-info":[{"award-number":["Small Grant Scheme \/ Newcastle University"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JDR Clinical &amp; Translational Research"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Persistent, painful temporomandibular disorders (TMDs) are challenging to manage and usually require the active engagement of patients. To achieve this, it is necessary to understand the complex and multifactorial nature of persistent pain. Many dental professionals have little education about persistent pain and may prefer to offer structural management and advice. This research aims to explore how people understand their persistent TMD and how this understanding has been influenced by their treatment providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Twenty-one people were recruited to represent a diversity of experience with persistent TMD. Interviews followed a semistructured topic guide. Themes were constructed through reflexive thematic analysis to represent how people made sense of their symptoms and the messages that they had picked up through their treatment journey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Participants described examples of conflicting opinions and inconsistent management recommendations. They rarely recalled collaborative discussions about the nature and complexity of their symptoms and different options for treatment. This experience is represented by a single theme, \u201ca medical merry-go-round.\u201d Subthemes of \u201ca medical journey to nowhere\u2014participants\u2019 frustrated attempts to find medical management that will end their pain\u201d and \u201cis it me?\u2014participants\u2019 questioning their role in persisting pain\u201d kept participants on the merry-go-round, while symptom resolution and participants\u2019 emerging development of a holistic understanding of their TMD pain provided exit points. Understanding pain holistically tended to be helpful and typically occurred despite rather than because of the advice given in routine treatment settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Participants in this study had not typically found their pain management within dental and medical settings to have helped them to construct meaning and understand their experiences of painful TMD. However, understanding symptoms holistically was experienced as beneficial. This study suggests that improved communication and signposting within services for persistent TMD may be beneficial to patients with TMD pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Knowledge Transfer Statement:<\/jats:title>\n                    <jats:p>Results of this study confirm that being offered a series of anatomically based, singular-cause explanations for persisting pain symptoms had been experienced as unhelpful by the participants who had sought help for their TMD. Participants highlighted the importance of accurate and collaborative communication and of dental professionals explicitly adopting and communicating a biopsychosocial understanding of pain to their patients who have TMD. Results highlight that some people can struggle to manage persisting pain with minimal support. Signposting patients to appropriate services and resources may help them to understand more about the nature of persistent pain and methods of managing it.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23800844231216652","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T04:02:54Z","timestamp":1704254574000},"page":"358-367","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Filling in the Gaps. Making Sense of Living with Temporomandibular Disorders: A Reflexive Thematic Analysis"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-7041","authenticated-orcid":false,"given":"C.","family":"Penlington","sequence":"first","affiliation":[{"name":"Newcastle University Faculty of Medical Sciences, Newcastle, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Durham","sequence":"additional","affiliation":[{"name":"Newcastle University Faculty of Medical Sciences, Newcastle, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Northumbria University Department of Psychology, Newcastle upon Tyne, Tyne and Wear, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Green","sequence":"additional","affiliation":[{"name":"Newcastle University Faculty of Medical Sciences, Newcastle, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"bibr1-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1177\/0017896911419350"},{"key":"bibr2-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1080\/14767430.2020.1734736"},{"key":"bibr3-23800844231216652","doi-asserted-by":"publisher","DOI":"10.11607\/ofph.1184"},{"key":"bibr4-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"bibr5-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1704846"},{"key":"bibr6-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12661"},{"key":"bibr7-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1586\/ern.12.82"},{"key":"bibr8-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12165"},{"key":"bibr9-23800844231216652","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.12461"},{"key":"bibr10-23800844231216652","unstructured":"Creswell J. 2007. 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