Temporomandibular Disorders: Association between Psychosocial Symptoms and Persistent Pain
This longitudinal study of temporomandibular disorder (TMD) reports the association of psychosocial dysfunctions (depression, somatization without pain, somatization, and anxiety) with characteristic pain intensity (CPI), pain interference (PI), and number of disability days (DD) for subjects with TMD. Subjects (N=330) underwent a thorough series of assessments at baseline and follow-up (5-10 years later) to receive both Axis I and Axis II diagnoses per the Research Diagnostic Criteria for TMD (RDC/TMD). They reported their levels of CPI, PI, and DD at baseline and follow-up. Linear and log-binomial regression analyses were used to evaluate the change in CPI and PI and assess the risk of DD by baseline categories of psychosocial symptoms as measured by the Symptom Checklist (SCL-90). Linear regression analysis revealed that subjects with depression at baseline had higher PI at follow-up. Also, subjects with moderate to severe somatization with and without pain had higher CPI at follow-up than subjects without somatization. In conclusion, we found that psychosocial impairments (depression, somatization) were associated with increased characteristic of pain intensity, pain interference, and disability days at follow-up.
TMJ Disorders - NIDCR Home. National institute of dental & craniofacial research. http://nidcr.nih.gov/oralhealth/topics/tmj/tmjdisorders.htm. Accessed October 23, 2016.
Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of Oral & Facial Pain and Headache. 2014;28(1):6-27. doi:10.11607/jop.1151.
Visscher CM, Lobbezoo F, de Boer W, van derMeulen M, Naeije M. Psychological distress in chronic craniomandibular and cervical spinal pain patients. Eur J Oral Sci. 2001; 109:165– 171.
Dworkin, S.F. and LeResche, L., Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique, J. Craniomandib. Disord. Fac. Oral Pain, 6 (1992) 301–355
National Institute of Dental and Craniofacial Research [7/28/2013]; Facial Pain. http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/FacialPain/ [Ref list]
Maísa Soares G, Rizzatti-Barbosa CM. Chronicity factors of temporomandibular disorders: A critical review of the literature. Braz Oral Res. 2015;29: pii: S1806-83242015000100300
Prevalence of mandibular dysfunction in young adults. Solberg WK, Woo MW, Houston JBJ Am Dent Assoc. 1979 Jan; 98(1):25-34
Martins-Junior RL, Palma AJ, Marquardt EJ, Gondin TM, de Kerber FC. Temporomandibular disorders: a report of 124 patients. J Contemp Dent Pract. 2010; 11:071–8.
Van Loon JP, de Bont LG, Stegenga B, Spijkervet FK, Verkerke GJ. Groningen temporomandibular joint prosthesis. Development and first clinical application. Int J Oral Maxillofac Surg. 2002;31:44–52.
Isong U, Gansky SA, Plesh O. Temporomandibular joint and muscle disorder-type pain in U.S. adults: the National Health Interview Survey. J Orofac Pain 2008; 22: 317–322.
Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults. J Am Dent Assoc. 1979;98:25–34.
Carlsson GE, LeResche L. Epidemiology of temporomandibular disorders. In: Sessle BJ, Bryant P, Dionne R, editors. Temporomandibular disorders and related pain conditions. Seattle: IASP Press; 1995. pp. 497–506
Lipton JA, Ship JA, Larach-Robinson D. Estimated prevalence and distribution of reported orofacial pain in the United States. J Am Dent Assoc. 1993;124:115–21.
Kirveskari P, Alanen P, Jämsä T. Association between craniomandibular disorders and occlusal interferences in children. J Prosthet Dent. 1992;67:692–6.
Oral K, Bal Küçük B, Ebeoglu B, Dinçer S. Etiology of temporomandibular disorder pain. Agri.2009;21:89–94.
Furquim BD, Flamengui LM, Conti PC. TMD and chronic pain: A current view. Dental Press J Orthod.2015;20:127–33.
Kolbinson DA, Epstein JB, Burgess JA, Senthilselvan A. Temporomandibular disorders, headaches, and neck pain after motor vehicle accidents: A pilot investigation of persistence and litigation effects. J Prosthet Dent. 1997;77:46–53.
Grzesiak RC. Psychologic considerations in temporomandibular dysfunction. A biopsychosocial view of symptom formation. Dent Clin North Am. 1991;35:209–26.
Shaefer JR, Holland N, Whelan JS, Velly AM. Pain and temporomandibular disorders: A pharmaco-gender dilemma. Dent Clin North Am. 2013;57:233–62.
Christensen L, Luther F. Adults seeking orthodontic treatment: Expectations, periodontal and TMD issues. Br Dent J. 2015;218:111–7.
McNeely ML, Armijo Olivo S, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther. 2006;86:710–25.
Treacy K. Awareness/relaxation training and transcutaneous electrical neural stimulation in the treatment of bruxism. J Oral Rehabil. 1999;26:280–7.
Fricton JR. Management of masticatory myofascial pain. Semin Orthod. 1995;1:229–43.
Dimitroulis G, Gremillion HA, Dolwick MF, Walter JH. Temporomandibular disorders. 2. Non-surgical treatment. Aust Dent J. 1995;40:372–6.
Dionne RA. Pharmacologic treatments for temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:134–142.
Kalamir, A., H. Pollard, A. L. Vitiello, and R. Bonello. TMD and the problem of bruxism—a review. J. Bodywork Mov. Ther. 11:183–193, 2007. doi:10.1016/j.jbmt.2006.11. 006.
Glaros, A. G., Z. Owais, and L. Lausten. Reduction in parafuncational activity: a potential mechanism for the effectiveness of splint therapy. J. Oral Rehabil. 34:97–104, 2007. doi:10.1111/j.1365-2842.2006.01660.x.
Glass, E. G., A. G. Glaros, and F. D. McGlynn. Myofascial pain dysfunction: treatments used by ADA members. Cranio 11:25–29, 1993.
Forssell, H., and E. Kalso. Application of principles of evidence-based medicine to occlusal treatment for temporomandibular disorders: are there lessons to be learned? J. Orofac. Pain 18:9–22, 2004; discussion 23–32.
Kreiner, M., E. Betancor, and G. T. Clark. Occlusal stabilization appliances. Evidence of their efficacy. J. Am. Dent. Assoc. 132:770–777, 2001.
Nitzan DW, Price A. The use of arthrocentesis for the treatment of osteoarthritic temporomandibular joints. J Oral Maxillofac Surg. 2001;59:1154–9. discussion 1160.
Holmlund A, Hellsing G, Bang G. Arthroscopy of the rabbit temporomandibular joint. Int J Oral Maxillofac Surg. 1986;15:170–5.
Holmlund A. Diagnostic TMJ arthroscopy. Oral Surg Oral Diagn. 1992;3:13–8.
Dolwick MF. The role of temporomandibular joint surgery in the treatment of patients with internal derangement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:150–5.
Rammelsberg P, Leresche L, Dworkin SF, Mancl L. Longitudinal outcome of temporomandibular disorders: a 5-year epidemiologic study of muscle disorders defined by research diagnostic criteria for temporomandibular disorders. J Orofac Pain 2003;17: 9–20.
Kalaykova S, Lobbezoo F, Naeije M. Twoyear natural course of anterior disc displacement with reduction. J Orofac Pain 2010;24:373–8.
Manfredini D. Fundamentals of TMD management. In: Manfredini D, editor. Current
concepts on temporomandibular disorders. Berlin: Quintessence Publishing; 2010 . p. 305– 18.
Dworkin SF, Massoth DL. Temporomandibular disorders and chronic pain: disease or illness? J Prosthet Dent 1994;72:29–38.
Yap AUJ, Tan KBC, Chua EK, Tan HH. depression and somatization in patients with temporomandibular disorders. J Prost Dent. 2002;88:479–484. doi: 10.1067/mpr.2002.129375
Zakrzewska JM, Harrison SH. Assessment and management of orofacial pain. Pain research and clinical management. Amsterdam. Elsevier; 2002
Sipila K, Veijola J, Jokelainen J, Jarvelin MR, Oikarinen KS, Raustia AM, et al. Association between symptoms of temporomandibular disorders and depression: an epidemiological study of the Northern Finland 1966 Birth Cohort. Cranio 2001;19:183–7.
Glaros AG, Lumley MA. Alexithymia and pain in temporomandibular disorder. Journal of Psychosomatic Research 2005;59:85–8.
Auerbach SM, Laskin DM, Frantsve LM, Orr T. depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients. Journal of Oral and Maxillofacial Surgery 2001;59:628–33. (discussion 34).
Lindroth JE, Schmidt JE, Carlson CR. A comparison between masticatory muscle pain patients and intracapsular pain patients on behavioral and psychosocial domains. Journal of Orofacial Pain 2002;16:277–83.
Okeson JP. Bell's orofacial pains. Sixth. Chigago: Quintessence Publishing; 2005.
Turner JA, Dworkin SF. Screening for psychosocial risk factors in patients with chronic orofacial pain: recent advances. Journal of the American Dental Association 2004;135:1119– 25. (quiz 64–5).
Korszun A, Hinderstein B, Wong M. Comorbidity of depression with chronic facial pain and temporomandibular disorders. Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics 1996;82:496–500.
Gerschman JA, Wright JL, Hall WD, Reade PC, Burrows GD, Holwill BJ. Comparisons of psychological and social factors in patients with chronic oro-facial pain and dental phobic disorders. Australian Dental Journal 1987;32:331–5.
Mongini F, Ciccone G, Deregibus A, Ferrero L, Mongini T. Muscle tenderness in different headache types and its relation to anxiety and depression. Pain 2004;112:59–64.
Mongini F, Ciccone G, Ceccarelli M, Baldi I, Ferrero L. Muscle tenderness in different types of facial pain and its relation to anxiety and depression: a cross-sectional study on 649 patients. Pain 2007;131:106–11.
Wright AR, Gatchel RJ, Wildenstein L, Riggs R, Buschang P, Ellis 3rd E. Biopsychosocial differences between high-risk and low-risk patients with acute TMD-related pain. Journal of the American Dental Association 2004;135:474–83.
Vassend O, Krogstad BS, Dahl BL. Negative affectivity, somatic complaints, and symptoms of temporomandibular disorders. Journal of Psychosomatic Research 1995;39:889–99.
Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surgery Oral Medicine and Oral Pathology 1985;60:615–23.
Korff MV, Dworkin SF, Resche LL. Graded chronic pain status: an epidemiologic evaluation. Pain. 1990;40(3):279-291. doi:10.1016/0304-3959(90)91125-3.
Derogatis LR, Cleary PA. Confirmation of the dimensional structure of the scl-90: A study in construct validation. Journal of Clinical Psychology J Clin Psychol. 1977;33(4):981-989.doi:10.1002/1097-4679(197710)33-4
Arrindell W, Ettema J. Handleiding bij een multidisciplinaire psychopathologie-indicator. Lisse: Swets & Zeitlinger; 1986.
Bech P, Bille J, Møller S, Hellström L, Østergaard S. Psychometric validation of the Hopkins Symptom Checklist (SCL-90) subscales for depression, anxiety, and interpersonal sensitivity. Journal of Affective Disorders. 2014;160:98-103.
Dworkin SF, Von Korff M, LeResche L. Multiple pains and psychiatric disturbance. An epidemiological investigation. Arch Gen Psychiatry 1990; 47:239-44.
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