Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

22 questions · 30 findings · 5 reviews · Oral Health

No studies found 6 · 20%GRADE not reported 9 · 30%Very low 3 · 10%Low 12 · 40%Moderate 0 · 0%High 0 · 0%

CBT vs control (e.g. usual activities)

Daily mean opiate intake per hour · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Cognitive behavioural therapy showed no clear difference in daily mean opiate intake per hour compared with control (treatment as usual); GRADE not reported.

1 finding from 1 review

CBT vs control (e.g. usual activities)

Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Cognitive behavioural therapy showed no clear difference in average pain scores (0-100 VAS) compared with control (treatment as usual); GRADE not reported.

1 finding from 1 review

CBT vs alternative treatment

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs alternative treatment

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower psychological distress at follow-up compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.
    1 study · 101 participants
    Very low

CBT vs alternative treatment

Additional physical symptoms · People aged 12 years and over with painful TMD lasting 3 months or longer

The review found no eligible studies for this question.

1 finding from 1 review

CBT vs alternative treatment

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in disability caused by pain at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower pain intensity at follow-up (12 months) compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain disability at treatment completion compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in psychological distress at follow-up compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

CBT vs alternative treatment

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • SoF: 3 studies reported minor adverse events in the control group; 1 study reported minor adverse events in psychological therapy group; 1 study reported that there were no adverse events. Results: NCT00066937 minor…
    5 studies
    Very low

CBT vs No special instructions (control)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults undergoing orthodontic treatment

Cognitive behavioural therapy (CBT) led to lower patient‐reported pain intensity or pain relief (VAS, NRS or… compared with no special instructions (control); GRADE not reported.

3 findings from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower pain intensity (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Muscle palpation pain (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… showed no clear difference in muscle palpation pain (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review
  • Psychosocial interventions for the management of chronic orofacial pain 2011 · Cochrane All outcomes
    Long term (more than 3 months)
    Muscle palpation pain long term (greater than 3 months): 3 studies; results not pooled owing to substantial heterogeneity (I2=64%); insufficient evidence to draw conclusions for any individual intervention. One study…
    3 studies
    GRADE not reported

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Depression (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower depression (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Reduction in pain intensity · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to higher pain intensity (short term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review