A learning health system approach treating temporomandibular disorder as a biopsychosocial chronic-pain condition.

The care integration model

This initiative integrates care for patients with temporomandibular disorders (TMD) into a broader, coordinated medical and behavioral health care model. The approach leverages a learning health system (LHS) infrastructure, embedding standardized assessment, shared care pathways, and data integration within the electronic health record (EHR) to support multidisciplinary management of TMD as a chronic pain condition.

Who it serves

The model serves patients with TMD and related orofacial pain conditions seen within an integrated delivery system (HealthPartners Dental Group and Medical Group). Many patients present with comorbid chronic pain, mental health conditions (e.g., anxiety, depression), and high health care utilization, requiring a coordinated, multi-disciplinary approach to care.

The problem to be solved

Traditional TMD care has been siloed within dentistry, despite strong evidence that TMD is a biopsychosocial condition requiring interdisciplinary care. This fragmentation leads to delayed diagnosis, inconsistent treatment, limited access to behavioral therapies, and suboptimal outcomes. The initiative addresses the lack of integration between dental, medical, and behavioral care systems.

Current status

The model has been implemented within the HealthPartners clinics and scaled across the broader care system. Core components include structured patient assessments, risk assessment, referral pathways, and interdisciplinary collaboration. This model is now operational, with ongoing refinement based on current evidence. It has been expanded to include sleep medicine and conditions.

Outcomes

• Improved identification of high-risk patients using standardized assessment tools
• Increased referrals to behavioral health and physical therapy services
• Reduction in unnecessary imaging and procedural interventions
• Positive patient-reported outcomes related to pain and function