Comparison of Different Predoctoral Educational Modalities on Knowledge Levels in Temporomandibular Disorders: A National‐Based Cross‐Sectional Study
Danica Tuason, Caroline M. Sawicki, James Fricton, Janey Prodoehl, Stephen Palatinus, Linda Sangalli
Abstract
OBJECTIVE: With the recognition of orofacial pain as dental specialty, the Commission on Dental Accreditation (CODA) mandated temporomandibular disorders (TMD) education in all US predoctoral dental programs. Yet, no study has evaluated whether current curricula adequately enhances students' knowledge of TMD pathology and management. This study assessed TMD knowledge among US predoctoral dental students and examined the impact of specific educational modalities on knowledge scores. METHODS: An anonymous 61-item REDCap survey was distributed in Fall 2024 via the American Student Dental Association to students enrolled in CODA-accredited programs, assessing TMD knowledge (38-item, on pathophysiology, chronic pain, psychophysiology, and psychiatric disorders); exposure to different teaching modalities (5-item); confidence levels (13-item); and demographics (5-item). Scores were compared against TMD experts from published literature and across academic years, prior clinical exposure, and educational modalities (multimodal vs. single-modality) using ANOVA and t-tests. Logistic regression tested whether specific educational approaches (didactic-only vs. didactic + patient clinical exposure vs. didactic + hands-on on peers/small-group discussion) predicted sufficient knowledge scores (> 50% correct answers). RESULTS: Among 283 respondents (26.2 ± 3.7 years old, 68.9% women; 17.2% first-year, 30.7% second-year, 28.7% third-year, 23.1% fourth-year), students demonstrated low TMD knowledge compared to TMD experts (38.6% correct answers, range 0.0%-77.8%), which significantly improved with academic years (p < 0.001). Multimodal instruction (17.5 ± 5.9 vs. 11.2 ± 7.1, p < 0.001), prior patient exposure (18.4 ± 6.6 vs. 16.0 ± 6.3, p = 0.028), and combining didactic teaching with clinical exposure (18.1 ± 6.3 vs. 7.5 ± 6.3, p < 0.001) significantly enhanced knowledge. Academic year (third-year: p = 0.041, odds ratio [OR] = 5.33; fourth-year: p = 0.008, OR = 9.34) and combining didactic teaching with clinical exposure (patient exposure: p = 0.005, OR = 3.22; hands-on on peers/small-group discussion: p = 0.030, OR = 2.44) predicted sufficient knowledge. CONCLUSION: While knowledge of TMD pathology and management among students was generally low, academic progression, multimodal instruction, and patient exposure significantly improved performance. Integrating clinical exposure along with traditional instruction may enhance TMD knowledge.