Yemen study highlights gaps in dental TMD care

Dental Tribune International

Fri. 23. October 2026

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SANA’A, Yemen: Previous research has identified gaps in dentists’ knowledge and use of physical therapies for temporomandibular disorder (TMD), but little is known about these challenges in conflict-affected healthcare settings. To help identify priorities for professional education and healthcare planning, researchers in Yemen surveyed dentists in Sana’a. Based on their findings, the researchers proposed targeted training and practical approaches to TMD management suited to local healthcare constraints.

The cross-sectional study assessed 426 dental professionals, including general dental practitioners and specialists working in universities, private dental clinics and government hospitals. It assessed their knowledge of evidence-based physical modalities for TMD management, their beliefs regarding treatment effectiveness, their clinical practices and barriers to TMD care. The researchers also examined the influence of professional qualifications, clinical experience and previous TMD training.

While most respondents recognised the evidence supporting jaw exercises and manual therapy, fewer than half reported using jaw exercises often or always, and only around a third reported using manual therapy regularly. Knowledge was weaker regarding the limitations of heat and ultrasound therapy for long-term management and the potential role of dry needling. Nearly half also did not recognise that appropriately trained dentists could provide certain physical interventions themselves.

Most respondents recognised the importance of patient self-management. Nevertheless, only around half said they used patient education and home-based self-management often or always. Similarly, only just over half reported that they regularly monitored patients’ adherence to treatment and self-care plans. The researchers highlighted patient education and support for self-management as important areas for improving TMD care, given the limited availability of physiotherapy services.

Barriers to physical therapy use and training needs

The contrast between respondents’ generally favourable attitudes towards physical therapies and their reported use suggests that barriers to implementing these approaches extend beyond gaps in knowledge alone. The main barriers identified were limited access to physiotherapy resources or equipment and a lack of formal training in physical therapy techniques. Respondents also cited patients’ limited awareness of TMD management, clinical time constraints and treatment costs. In Yemen, these barriers must be considered in the context of prolonged conflict that has severely disrupted healthcare services.

Attendance of a TMD course or workshop was strongly associated with better knowledge, more favourable attitudes and more frequent reported use of physical treatments. Similar findings were made for dentists who treated more TMD patients.

In light of their findings, the researchers proposed combining online learning with practical workshops to make training more accessible in light of geographical and security constraints. They also recommended training dentists to provide simple physical interventions, such as guidance on jaw exercises and posture correction, within their professional scope.

The study, titled “Physical modalities for temporomandibular disorders: A cross-sectional survey of knowledge, perceptions, and practice patterns among dental professionals in Sana’a, Yemen”, was published on 6 October 2026 in Clinical, Cosmetic and Investigational Dentistry.