Care network for individuals with temporomandibular disorders in the Brazilian Unified Health System: Perspective of managers and dental surgeons

OBJECTIVE: To analyze the care network for individuals with orofacial pain (OFP) and temporomandibular disorders (TMD) in the Brazilian Unified Health System (SUS). METHODS: Oral health managers and primary health care (PHC) dentists completed electronic questionnaires addressing service availability, clinical practices, knowledge-related items, and referral services for TMD and OFP. Data were statistically analyzed at a significance level of 5% (p < .05). RESULTS: Most managers reported that neither PHC (n = 82; 85.4%) nor secondary care (n = 68; 70.8%) treats patients with TMD. Most dentists reported not treating TMD patients (n = 209; 56.3%) and being unaware of public referral services (n = 268; 72.2%). Dentists' responses differed from evidence-based recommendations on TMD etiology, diagnosis, and treatment. Specialist status was associated with more evidence-consistent responses, particularly regarding traditional occlusal concepts. CONCLUSION: The findings suggest challenges in organizing TMD/OFP care within SUS, particularly regarding service availability, alignment of dentists' responses with current evidence, and awareness of referral pathways.