Higher Confidence Levels in Temporomandibular Disorders Among Predoctoral Students With Clinical Patient Exposure: A National-Based Cross-Sectional Study.

Abstract

Objective: The Commission on Dental Accreditation mandated the integration of temporomandibular disorders (TMD) education in predoctoral dental curricula by 2022. However, its impact on student confidence in managing patients with TMD, which is a crucial precursor to implementation, remains unexplored. This study assessed students' confidence levels in TMD-related skills and the influence of different educational approaches.

Methods: An anonymous survey assessing confidence in 12 TMD-related skills (rated 0-10, with 10='the most confident') was distributed to all U.S. predoctoral dental students via the American Student Dental Association in Fall 2024. Confidence levels were compared across academic years, instruction modality (multimodal vs. single-modality) and educational approach (didactic alone vs. didactic + clinical exposure vs. didactic + hands-on/small group discussions) using ANOVA and t-tests. Logistic regression identified predictors of sufficient confidence (> 5 on a 0-10 scale).

Results: Responses from 289 participants (26.2 ± 3.8 y/o, 69.3% women) revealed overall low confidence levels (3.5 ± 2.1). Confidence significantly increased with academic year, from 14% of first-year students to 59.4% of fourth-year students reporting sufficient confidence (p < 0.001). Students who received multimodal instruction (p < 0.001), didactic lecture combined with patient exposure (p's between < 0.001 and 0.021) and who had previous clinical exposure (p's between < 0.001 and 0.006) scored significantly higher in confidence than those receiving single-modality approaches, only didactic lecture, and those without patient exposure. Logistic regression identified patient exposure (OR = 2.88, 95% CI 1.11-7.51, p = 0.030) and later academic year (OR = 2.57, 95% CI 1.15-5.71, p = 0.021) as predictors of sufficient confidence.

Conclusions: Despite an overall low confidence in skills related to TMD, confidence levels improved with academic progression, multimodal instruction, and patient exposure.