An analysis of claims filed through insurance companies reveals that women are almost 10 times more likely than men to undergo TMJ surgery to treat temporomandibular disorders, or pain and discomfort associated with the joint that serves as the hinge for the lower jaw.
The study appeared in an issue of the Journal of the American Dental Association.
Researchers working with University of Medicine and Dentistry of New Jersey and Aetna Health Plans examined 46,293 patients with TMD-related claims between 1991 and 1993. Of the total, 1,666 underwent at least one of 10 TMD surgical procedures and filed a reimbursement claim for the surgery. Of these surgical patients, 1,500 were female and 166 were male -- a ratio of almost 10 to 1.
Researchers found that the ratio of female to male TMD surgical candidates is higher among the insurance company claims than previously reported estimates from health maintenance organizations or from the general population. Both groups estimated that the ratio of women to men with chronic facial pain was closer to 2 to 1.
Joseph J. Marbach, D.D.S., one of the UMDNJ researchers involved in the study, says there are several explanations for the wide gap between women, men and TMD surgery. "More women may seek treatment for TMD disorders so it stands to reason women would be more likely to become surgical candidates," he says.
Another explanation, says Dr. Marbach, is that women who experience unsuccessful non-surgical treatments may be more likely to persist in seeking surgery. He also pointed out that clinicians may recommend surgery more often for women than men.
Gender disparities for other surgical procedures have been widely reported. For example, men are more likely to undergo coronary bypass surgery and kidney transplantation surgery than women.
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