Received: 25 May 2020 | Accepted: 4 June 2020

DOI: 10.1111/jop.13068

SPECIAL ISSUE ARTICLE

Interprofessional Collaboration in Dentistry: Role of

physiotherapists to improve care and outcomes for chronic
pain conditions and sleep disorders

Alberto Herrero Babiloni1,2,3 | Jacqueline T. A. T. Lam4 | Fernando G. Exposto5,6 |

Gabrielle Beetz1 | Catherine Provost1 | Dany H. Gagnon4 | Gilles J. Lavigne1,2,3

1
Sacre-Cœur Hospital, CIUSS du Nord-de-
l'île-de-Montréal, Montreal, Canada Abstract
2
Faculté de Medicine Dentaire, Université de Physiotherapists can manage chronic pain patients by using technical interven-
Montréal, Montreal, Canada
tions such as mobility, strengthening, manual therapy, or flexibility in a specific and
3
Division of Experimental Medicine, McGill
University, Montreal, Canada
functional manner, being a key component of a multidisciplinary team. Dentists are
4
School of Rehabilitation, Faculty of involved in the management of different chronic pain conditions such as temporo-
Medicine, Université de Montréal, Montreal, mandibular disorders and sleep disorders such as obstructive sleep apnea. However,
Canada
5 they are frequently unaware of the benefits of collaborating with physical therapists.
Section of Orofacial Pain and Jaw Function,
Department of Dentistry, Aarhus University, In this review, the collaboration of physical therapists and dentists will be explored
Aarhus, Denmark
6
when managing orofacial pain, headaches, and sleep disorders. The physical therapist
Scandinavian Center for Orofacial
Neurosciences (SCON), Aarhus, Denmark is important in the management of these disorders and also in the screening of risk
factors.
Correspondence
Alberto Herrero Babiloni, Faculte de
KEYWORDS
medecine dentaire, Universite de Montreal,
CP 6128, Succ Centre-ville, Montreal, headache, multidisciplinary team, orofacial pain, physical therapy, sleep, temporomandibular
Canada, H3C 3J7. joint disorders
Email: herre220@umn.edu

1 | I NTRO D U C TI O N with other healthcare professionals, physiotherapists are a key com-

According to the World Health Organization (WHO), physiotherapists
“assess, plan and implement rehabilitative programs that improve or
restore human motor functions, maximize movement ability, relieve
pain syndromes, and treat or prevent physical challenges associated
with injuries, diseases, and other impairments”.1 Thus, physiotherapists
may manage patients by using therapeutic interventions (ie, mobility,
strengthening, manual therapy, and flexibility) in a specific and func-
tional manner to succeed.
Each healthcare professional has strengths and expertise lim-
itations that can be complemented by other professionals, and it is
thought that multidisciplinary treatment is the most beneficial strat-
2
egy when treating many conditions, including chronic pain. Along
ponent of the multidisciplinary pain team, as they are able to reduce
pain and increase function by implementing reversible and non-inva-
sive therapies.3
Dentists, who most often interact with other healthcare profes-
sionals such as physicians, pharmacists, or psychologists, may not be
fully aware of the benefits of collaborating with physiotherapists.4
Indeed, physical therapy (PT) is especially relevant in the manage-
ment of orofacial pain, such as temporomandibular disorders (TMD)
and sleep disorders, such as obstructive sleep apnea (OSA) (Figure 1).
Moreover, they can be helpful in managing certain types of headache.
Therefore, the objective of this review is to describe the potential con-
tribution of physiotherapy in collaboration with dentistry in the man-
agement of orofacial pain, headaches, and sleep disorders.

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

J Oral Pathol Med. 2020;00:1–9.  wileyonlinelibrary.com/journal/jop | 1

2 |
2 | PH YS I C A L TH E R A PY I N O RO FAC I A L
PA I N
Orofacial pain is a general term covering any pain felt in the mouth,
jaw, or face. Physiotherapists are an important team member in man-
aging orofacial pain disorders and in screening for sinister conditions
that can manifest as pain in the orofacial area, for example by iden-
tifying risk factors as “red flags” (ie, warning signals of more serious
pathologies) (Figure 2) (Table 1).
2.1 | Temporomandibular disorders
Temporomandibular disorders (TMD) is an umbrella term that rep-
resents a series of disorders that affect the temporomandibular
joint (TMJ) and/or the masticatory muscles, being frequently ac-
5
companied by pain, joint noises, and decreased function. TMD
is the most common orofacial pain condition after odontogenic
pain, affecting around 12% of the general population. 6 TMD affect
more females, and their onset may be initiated by trauma or micro-
7
trauma. Moreover, other health comorbidities, non-painful orofa-
cial pain symptoms, self-reports of jaw parafunction, and somatic
symptoms are also considered as predictors of clinical TMD. 8 TMD
are diagnosed clinically using the diagnostic criteria for TMD (DC/
HERRERO BABILONI et al.
F I G U R E 1 The relationship between
the dentist and the physiotherapist within
a multidisciplinary team. OSA, obstructive
sleep apnea; TMD, temporomandibular
disorders
TMD),9 and the first line recommendations for their management
are conservative modalities, including PT interventions.10 In indi-
viduals with TMD, PT can decrease pain, restore normal mastica-
tory function, and minimize parafunctions that could potentially
lead to TMD chronification.11 Painful TMD can be divided into
articular (ie, arthralgia), if the pain originates in the joint itself ,
or muscular (ie, myofascial pain), if it originates in the muscles
of mastication. Although TMD patients often present with both,
physiotherapists should consider that treatment might vary for
one or the other. Interventions that physiotherapists often use in
TMD management can be classified as educational and behavioral
treatments, exercises, manual therapy, electrophysical modalities,
thermal modalities, and needling modalities (Table 2).
A. Educational and behavioral treatments. This category can refer
to “proven, safe methods that emphasize self-management and
acquisition of self-control over not only pain symptoms but also
their cognitive attributions or meanings and maintaining a pro-
ductive level of psychosocial function, even if pain is not totally
absent”.12 Education can help TMD patients understand the na-
ture of the disorder and reduce psychosocial distress. Self-care
strategies are critical for TMD management, as they can reduce
TMD contribution and perpetuating factors, change poor hab-
its/behaviors, and potentiate other management strategies.3
HERRERO BABILONI et al.
Systemic symptoms (fever, weight loss)
S
Secondary risk factors (human
cancer)
N
Neurological symptoms or abnormal
signs (confusion, impaired alertness,
or consciousness)
!
Screening
O Onset: sudden, abrupt,
or split-second Headaches
and
orofacial pain
Obstructive
sleep apnea
O
Older: new onset and progressive
headaches, especially in > 50 years
old (giant cell arteritis)
P
headache or different pattern (changes
in attack frequency, severity, or clinical
features)
FIGURE 2 Identification of red flags and risks factors in chronic pain and obstructive sleep apnea
TA B L E 1 Other red flags of sinister pathologies mimicking
temporomandibular disorders
History of malignancy: potential for new primary cancer, recurrence,
or metastases
Presence of lymphadenopathy or neck masses: potential for
neoplastic, infective, or autoimmune cause
Sensory or motor function changes in cranial nerves: potential for
intracranial causes or malignancy
Recurrent epistaxis, purulent nasal drainage, or anosmia: potential
for nasopharyngeal carcinoma or chronic sinusitis
Facial asymmetry or masses: potential for neoplastic, infective, or
inflammatory causes
Occlusal/bite changes: potential for growth disturbance of condyle
including neoplasia and/or rheumatoid arthritis
Persisting or worsening symptoms despite treatment
History of recent head and/or neck trauma
Atypical pain in orofacial area (eg, angle of the mandible) that
increases with physical exercise: potential for cardiac origin
Note: Adapted from Michael Karegeannes with permission.75
Although effects are moderate, biofeedback on muscle ten-
sion, clenching awareness, stress management, relaxation tech-
niques, and physical self-regulation can be beneficial.12,13 While
“hands-on” interventions can provide direct relief and benefits,
it is thought that education and implementation of home-based
exercises programs are the ultimate strategy in TMD, as they re-
duce dependence to treatment while increasing compliance.
B. Exercises and self-exercise therapy. An exercise program that may
include masticatory relaxation exercises, massage, and strength-
ening can be developed and implemented together with the
patient.14 Stretching, relaxation, strengthening, and endurance
exercises can be beneficial, but have not found to be superior to
other conservative treatments such as self-care.15 Coordination
| 3
Lifestyle
Smoking, alcohol, sedentary life
style, sleep habits and routine,
supine dominant and sleep position,
life and eating habits, fatty meals
Demographic
Age (50 years old), being a
male, being overweight to
obese, being a woman in post-
menopause life stage
!
Clinical craniofacial and
oropharyngeal characteristics
! Large neck, retrognathia/retracted
mandible and/or maxilla, long soft
palate, etc.
Use of respiratory depressive
medications
Opioids, benzodiazepines,
barbiturates
exercises are thought to improve motor control (ie, decrease
muscle imbalance) and reduce muscular pain.14 A widely used co-
ordination exercise routine is the 6 × 6 proposed by Rocabado;
however, it showed no additional therapeutic benefit for masti-
catory muscle pain over self-care.16
C. Manual therapy. Manual therapy includes soft tissue treatment
(myofascial release of neck and jaw, cranial-sacral therapy, and
trigger points), mobilization (mandibular distraction, mandib-
ular translation, and cervical mobilization), and manipulation
(high-velocity low amplitude thrusts). Overall, they seem effec-
tive in decreasing TMD pain and increasing function.17 Despite
its potential effects, high-velocity low amplitude (HVLA) cervical
mobilization carries a high degree of risk due to the risk of cervi-
cal or carotid artery dissection. Although causality has not been
recognized between HVLA and artery dissection,18 the clinician
should be careful when using HVLA techniques.
Combining exercises and manual therapy showed promising results
on both pain and pain-free maximum mouth opening in TMD patients.19
Moreover, in combination with other non-invasive therapies, PT has
shown a similar effectiveness as surgery in reducing symptomatology
of “closed lock” (ie, disk displacement without reduction), becoming
one of the first treatment choices for these cases.20 Even though most
of this research has low evidence levels, these interventions are safe,
simple, and reversible, thus being relevant for TMD management.
D. Electrophysical modalities. Electrotherapy is a common modal-
ity in PT that encompasses many devices built to affect the
physiological processes. In TMD, the transcutaneous electrical
nerve stimulation (TENS), biofeedback, low-level laser therapy,
ultrasound, and iontophoresis are the most commonly used ap-
proaches. It appears that low-level laser therapy could decrease
inflammatory substances and also pain, but there are still not
4 | HERRERO BABILONI et al.

TA B L E 2 Summary of physical therapy techniques in the management of orofacial pain, headaches, and sleep disorders, including
examples and qualitative level of evidence

Disorders Techniques Examples Level of Evidence

TMD and headache Educational and behavioral Biofeedback on muscle tension Low to modest
attributed to TMD treatments Clenching awareness
Stress management relaxation techniques
Physical self-regulation
Exercises and self-exercise Masticatory relaxation exercises Low
therapy Massage
Strengthening
Stretching
Coordination exercises
Manual Therapy Soft tissue treatment (myofascial release of neck and Low
jaw, cranial-sacral therapy, and trigger points)
Mobilization (mandibular distraction, mandibular
translation, and cervical mobilization)
Manipulation (high-velocity low amplitude thrusts)
Electrophysical modalities Transcutaneous electrical nerve stimulation (TENS) Low
Biofeedback
Laser
Ultrasound
Iontophoresis
Thermal modalities Superficial heat Low
Cryotherapy
Needling modalities Acupuncture Low
Dry needling
Neuropathic and idiopathic Managed when comorbid Absent to low
pain musculoskeletal component
(eg, TMD)
Tension-type headache, Managed when musculoskeletal Trigger-point therapy (dry needling), craniocervical Low
migraine, and cervicogenic component present (eg, TMD) muscle training, spinal manipulation/mobilization,
headache and cervical exercises
Obstructive sleep apnea Myofunctional therapy Isotonic/isometric exercises targeting oral and Low to modest
oropharyngeal structures
Exercising Aerobic training and strength training with and Modest
without supervision
Electrical stimulation Non-invasive awake neuromuscular electrical Very low
stimulation (NMES)
Non-invasive brain stimulation Transcranial magnetic stimulation (TMS) Very low
Bruxism Exercises Stretching Very low
Biofeedback Electrical pulses devices (eg, Grindcare) Low to modest
Non-invasive brain stimulation Transcranial magnetic stimulation (TMS) Very low

Abbreviation: TMD, temporomandibular disorders.

enough data on the most optimal dose and parameters. 21 The
effect of ultrasound techniques seems to be limited on pain re-
15,22
lief, with inexistent to low evidence. The use of iontophoresis
with dexamethasone showed little improvements in function but
23
not in pain. In summary, the evidence in those techniques is
low, and more research is required to support their use.15
E. Thermal modalities. Superficial heat may lead to a significant de-
crease in pain and muscle tension. Indeed, an integrative review
showed benefits of superficial heat treatment for TMD (function
improvement including opening range of motion). 24 Cryotherapy
seems to reduce swelling and pain in acute musculoskeletal in-
juries by decreasing skin temperature and blood flow. Despite
its possible benefits in TMJ inflammation, there is no extended
research on the effect of cryotherapy on TMD. 25
F. Needling modalities. Acupuncture and dry needling are two tech-
niques that use needles but in different ways. Acupuncture uses
specific points to insert needles following the meridian of the
body, while dry needling uses a needle in a hyperactive muscle
at its trigger point. A meta-analysis showed that acupuncture
is better than placebo for reducing pain intensity in myalgias. 26
However, only 4 studies were included, so results need to be in-
terpreted with caution. As for dry needling, a relatively emerging
field in physiotherapy, it also appears somewhat beneficial when
compared to placebo, but based on only one study. 27
HERRERO BABILONI et al.
2.2 | Neuropathic and idiopathic pains
Neuropathic pain is caused by damage or disease affecting the so-
matosensory nervous system. 28 The benefit of PT in neuropathic
pain is controversial, as there is an important lack of scientific evi-
dence regarding its possible benefits. However, it can be considered
as an adjuvant treatment in cases where musculoskeletal structures
are also involved. 29
Trigeminal neuralgia (TN) is probably the most common neural-
gia presenting in the face, characterized by a unilateral shock-like,
short-lasting, and recurring extremely painful sensation confined
to the somatosensory distribution of one or more branches of the
trigeminal nerve.30 TN may co-exist with other orofacial pain con-
ditions, including TMD. In fact, the differentiation between both
entities can be challenging,31 and it is sometimes believed that TN
with continuous pain could be TN with co-existing TMD. In cases of
TN where musculoskeletal pain is also present, PT interventions in
the context of an interprofessional approach are indicated. However,
physiotherapists must consider patients’ TN pain “triggers” when se-
lecting an appropriate treatment modality.
Pain of unknown origin may also be called idiopathic pain. In the
orofacial area, two main idiopathic pain diagnosis are described:
(a) persistent idiopathic facial pain (PIFP) 32 and (b) persistent den-
toalveolar pain disorder (PDAP) which presents intraorally at a
site currently or previously occupied by a tooth. 33 Both are diag-
noses of exclusion, and their treatment is mainly based on edu-
cation about the condition and the use of topical, injectable, or
systemic medications. 32,34 As in TN, PT can be considered as an
adjuvant treatment in cases where musculoskeletal structures are
involved. 29
3 | PH YS I C A L TH E R A PY I N H E A DAC H E
DISORDERS
Studies show that PT is one of the most common management op-
tions for headache patients, being provided to 12.2%-52% of the
35
general population. Headache disorders should be diagnosed ac-
cording to the International Classification for Headache Disorders,
3rd edition (ICHD-3).36 In this classification, headaches are divided
into primary and secondary.36 Primary headaches are not the result
of another disorder, being a disorder themselves while secondary
headaches are caused by another disorder. Importantly, in this clas-
sification, a patient can have multiple headache diagnoses.
The most common primary headaches that may be related to
musculoskeletal dysfunction are migraine and tension-type head-
ache (TTH).37 The most common secondary headaches related to
musculoskeletal dysfunction are cervicogenic headache (CeH) and
headache attributed to temporomandibular disorders (HATMD).37
Among other reasons, they are important because pain from these
disorders can be referred to the teeth and the face.38 Moreover,
more sinister pathologies can cause headaches, and as such, the
presence of red flags should always be evaluated39 (Figure 2).
| 5
3.1 | Assessment of the headache patient
PT is most likely useful in headache management when the pa-
tient presents with musculoskeletal dysfunction of the neck and/
or masticatory system, and this dysfunction is either the cause or
contributing to the headache, such as in CeH and HATMD. In the
case of migraine and TTH, musculoskeletal dysfunction is most
likely to contribute to the headache complaint. Research shows that
not all TTH patients have increased pericranial tenderness (PCT) 40
and that increased PCT seen in headache patients is most likely a
consequence of increased headache frequency and not the cause
of the headaches.41 As such, it is important for physiotherapists to
make an appropriate assessment of the musculoskeletal system with
validated and standardized tests, as for example the craniocervical
flexion and flexion-rotation test, and the palpation of joints and trig-
ger points.5,42,43
In the case of the masticatory system, the gold standard for as-
sessment of TMD is the DC/TMD,9 which is divided into painful or
non-painful TMD. Since research shows that headache disorders are
mainly associated with painful TMD, especially myalgia, physiother-
apists may focus on the painful diagnoses.44 For the cervical system,
tests such as the craniocervical flexion test, flexion-rotation test,
joint palpation, and trigger-point palpation may be clinically useful
to assess headache patients.45 Figure 3 proposes an algorithm for
the assessment and management of headaches by physiotherapists.
3.2 | Evidence for physical therapy in the
management of headaches
Overall, there seems to be mixed evidence for the use of PT in the
management of headache disorders,42 and the choice of interven-
tion is mostly based on belief rather than on scientific evidence 42
(Table 2). In general, high-quality studies are lacking mostly due to
methodological flaws such as lack of appropriate classification of
headaches as well as different interventions and outcome meas-
ures.42,46 In addition, studies assessing the effects of PT on head-
ache disorders such as TTH and migraine do not assess if these
patients actually have musculoskeletal dysfunction.
Most studies and clinical opinions concur that PT for headache
management is most effective as part of a multidisciplinary effort.47
As such, patients with frequent headaches should be referred to a
physician (or at least a consultation should be made) so that phar-
macological management can be discussed and implemented, before
the patient can be referred again to the physiotherapist. Moreover,
a multi-modal approach seems to work better than one single mo-
dality and active PT treatment strategies are recommended, and as
such, patient participation is important.47
Evidence from systematic reviews has shown that PT modal-
ities are not equally effective for all headache types. Thus, ap-
propriate assessment and proper clinical reasoning should inform
whether or not PT is indicated, and whenever indicated, on the
choice of PT modality. For instance, studies seem to suggest that
6 |
aerobic exercise is effective for migraine management42 most
likely due to exercise-induced hypoalgesia that may play a role
48
in decreasing central nervous system excitability. However, if
an individual with migraine already undertakes adequate aerobic
exercise, this treatment modality may not be as effective as an-
ticipated and most likely not recommended. On the other hand,
even though manual therapy does not seem to have an effect on
49
migraine in cases where migraine patients clearly have increased
PCT, it would be clinically reasonable to direct treatment to the
pericranial muscles.
In the case of TTH, treatments that have been shown to possi-
bly have an effect are trigger-point therapy and craniocervical muscle
training.42 However, studies assessing the efficacy of PT in TTH do
not differentiate between those with and without musculoskeletal
dysfunction and perhaps this is why the evidence is not convincing.
Future research should assess differences between these groups
for interventions aimed at normalizing the musculoskeletal system.
HERRERO BABILONI et al.
F I G U R E 3 3 Possible care pathway
for the assessment and management
of headaches by physiotherapists. PT,
physical therapy; TTH, tension type
headache
Regarding trigger-point therapy, such as dry needling, it should be
mentioned that the existence of trigger points remains controversial50
and that it actually seems that referred pain may be an epiphenome-
non of the muscle unrelated to trigger points.51 In addition, studies
assessing the effects of dry needling usually have a high degree of
bias,52 and the beneficial effect that is seen in dry needling could be
due to activation of descending inhibitory mechanisms.50 Regarding
CeH, it seems that the most effective treatments are spinal manip-
ulation/mobilization and cervical exercises,42,53 most likely because
CeH is considered to be referred pain to the head originating from the
neck.54 However, spinal manipulation/mobilization as stated above
carries inherent risks that should be discussed with the patient.18
Regarding HATMD, there are no specific studies assessing the effect
of PT on this type of headache but it would be reasonable to direct
treatment to the masticatory system.10
In general, there seems to be evidence demonstrating that PT is
helpful in the management of headache disorders, especially in the
HERRERO BABILONI et al.
context of a multidisciplinary team.37 However, it is important that a
thorough evaluation of the musculoskeletal system, both cervical and
masticatory, is done to ascertain if indeed a musculoskeletal disorder
is present for PT to be deployed effectively. In addition, physiothera-
pists should know that OSA may be a reason for morning headaches,55
and as such, any patient presenting with morning headaches should
be screened for sleep apnea (Figure 2). Medication-overuse headache,
bruxism, or sinister pathologies can cause morning headaches as well,
so referral to a headache specialist is recommended.
4 | PH YS I C A L TH E R A PY I N S LE E P
DISORDERS
4.1 | Obstructive sleep apnea
Sleep apnea is a common sleep breathing disorder characterized
by complete cessation of breathing (apnea) or reduction in airflow
(hypopnea). It is associated with symptoms such as sleepiness and
fatigue, and it has serious health consequences.56 The most common
type of sleep apnea is obstructive sleep apnea (OSA), and it involves
obstruction of the upper airway during sleep. Continuous positive
airway pressure (CPAP) remains the gold-standard treatment for
57
OSA, even though adherence is modest. Valid treatment options
offered by PT include myofunctional techniques, physical exercise,
electrical stimulation, and the treatment of complications from oral
appliances (OA). Sleep medicine is now entering in the era of pre-
cision medicine. Phenotyping OSA patients according to their ana-
tomical (ie, vulnerable anatomy) and non-anatomical (ie, ineffective
airway dilator muscles, high probability of sleep arousal, and high
loop gain) traits is emerging as essential for its management.58-60
In this way, treatment options can be tailored according to patient
characteristics and preferences. For example, myofunctional ther-
apy could be utilized in individuals with ineffective airway dilator
muscles, while physical exercise could be targeted toward individu-
als with high probability of sleep arousals.59
Myofunctional therapy is a set of exercises including isotonic/
isometric exercises targeting oral and oropharyngeal structures,
and it has been reported that it can decrease the apnea-hypopnea
index (AHI) by 50% in adults and 62% in children.61 Physical exer-
cise, namely aerobic training and strength training with and with-
out supervision, has strong evidence in reducing AHI and daytime
sleepiness regardless of reduction in body mass index (BMI).62,63
Electrical or magnetic stimulation can be used to restore neuromus-
cular tone and increase upper airway patency. For instance, the use
of non-invasive awake neuromuscular electrical stimulation (NMES)
and transcranial magnetic stimulation (TMS) on dilator muscles has
shown promising results, although evidence is still low (Table 2).64,65
Importantly, OSA is considered a risk factor for developing
TMD,66 whereas TMD can be aggravated in patients with OSA
treated with oral appliances (OA). It has been shown that support
therapy (exercises to stretch the mandibular muscles used to control
| 7
pain and to restore mobility) was effective in managing TMD pain in
patients undergoing OA therapy,67 reason why its use should be con-
sidered in those cases. Additionally, physiotherapists can screen for
OSA risk factors and refer patients to the sleep physician, participate
in OSA management when indicated, and increase quality of life and
compliance in OSA patients using OA (Figure 2).
4.2 | Sleep bruxism
Sleep bruxism (SB), considered an oral behavior in otherwise healthy
persons,68 is a repetitive jaw-muscle activity characterized by clench-
ing or grinding of the teeth and/or by bracing or thrusting of the
mandible.69 SB can lead to dental problems (eg, dental attrition, hy-
persensitivity, pulpitis, and abfractions), muscle hypertrophy, and
pain.70 The most common management option for SB effects is the
use of mouthguards, but other alternative approaches are available.71
Nonetheless, evidence in the management of SB remains low for PT
mainly due to study design limitations. In fact, a recent study showed
that static stretching of masticatory muscles could have negative ef-
fects (increased number of burst).72 The application of experimental
techniques such as biofeedback using electrical pulses through de-
vices like Grindcare®73 or also TMS65,74 has shown promising results
(Table 2).
5 | CO N C LU S I O N
Interprofessional collaboration between dentists and physi-
otherapists has the potential to improve professional practice and
healthcare outcomes. Recognizing the potential contribution of
physiotherapists in the management of TMD, OSA, musculoskeletal-
related headaches, and other orofacial pain disorders is now essen-
tial. Moreover, physiotherapists are skilled to screen for risk factors
and red flags, refer to the specialist when appropriate, and partici-
pate in the treatment of these disorders within multidisciplinary
teams. Future high-quality mixed-method studies are required to es-
tablish the best model for dentists and physiotherapist interprofes-
sional practise for improving clinical care and healthcare outcomes.
AU T H O R C O N T R I B U T I O N
Alberto Herrero Babiloni: Conceptualization; Methodology;
Writing-original draft; Writing-review & editing. Jacqueline TAT
Lam: Writing-review & editing. Fernando G Exposto: Writing-review
& editing. Gabrielle Beetz: Visualization; Writing-review & edit-
ing. Catherine Provost: Writing-review & editing. Dany H Gagnon:
Writing-review & editing. Gilles J Lavigne: Funding acquisition;
Writing-review & editing.
PEER REVIEW
The peer review history for this article is available at https://publo​ns.
com/publo​n/10.1111/jop.13068.
8 | HERRERO BABILONI et al.

ORCID 18. Chaibi A, Russell MB. A risk–benefit assessment strategy to

exclude cervical artery dissection in spinal manual-therapy: a com-
Alberto Herrero Babiloni https://orcid.
prehensive review. Ann Med. 2019;51(2):118-127.
org/0000-0001-5588-5916 19. Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A.
Effectiveness of manual therapy and therapeutic exercise for tem-
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How to cite this article: Herrero Babiloni A, Lam JTAT,
Exposto FG, et al. Interprofessional Collaboration in
Dentistry: Role of physiotherapists to improve care and
outcomes for chronic pain conditions and sleep disorders.
J Oral Pathol Med. 2020;00:1–9. https://doi.org/10.1111/
jop.13068