This study investigated the clinical temporomandibular disorders (TMD), pain-related disability and psychological status of TMD patients using a computerized on-line TMD diagnostic system (NUS TMD v1.1). A total of 107 patients (32 male, 75 female) referred to the TMD clinics at the National Dental Centre and National University Hospital participated in this study. The mean age of the predominantly Chinese population (82.2%) was 30.8 years (range from 12 to 64 years). The history questionnaire and clinical examination were input directly into computers by patients and clinicians. A 'Summary of Findings' was then immediately generated by the program based on Axis I and II rules. The data was subsequently exported to SPSS for statistical analysis. About 20.6% of the patients had myofascial pain but only 7.5% experienced limited mandibular opening associated with myofascial pain. The majority of patients (> 80%) did not suffer from disc displacements (right and left joints). The frequency of arthralgia was also low (right joint 8.4%; left joint 7.5%) and only one patient had osteoarthosis of the TMJ. About 78.5% of the patients had low disability with almost equal distribution between low and high intensity pain, 27.1% of the patients were moderately depressed and 11.2% had severe depression. No significant difference in limitations related mandibular functioning scores was observed between normal/depressed patients and between patients with the different graded chronic pain severity classification. The three most frequent jaw disabilities were: eating hard foods (77.6%), yawning (75.7%) and chewing (64.5%). NUS TMD v1.1 is an extremely useful tool in the diagnosis/research of clinical TMD.
Our study suggests that, within two years, one in five patients with diabetes and a normal ankle-brachial index may have significant progression of peripheral arterial disease. Annual ankle-brachial index assessment and better control of hyperlipidaemia may thus be required for at-risk patients with poor glycaemic control, renal impairment and retinopathy.
Temporomandibular disorders (TMD) is a collective term embracing a number of clinical problems, which involve the masticatory musculature, the temporomandibular joint or both. Virtually all theories dealing with the aetiology and treatment of TMD have recognized the importance of psychological factors. This paper reports the development of a computerized on-line program (NUS TMD v1.1) for the diagnosis of pain-related disability and psychological status of TMD patients based on Axis II of the research diagnostic criteria (RDC)/TMD (Dworkin, S.F. & LeResche, L. 1992. Journal of Craniomandibular Disorders: Facial Oral Pain, 6, 301), which was developed to redress the lack of diagnostic criteria in TMD research. Methods adopted by RDC/TMD for use in assessing Axis II status include a seven-item questionnaire for grading chronic pain severity, the Symptom Checklist 90 Revised (SCL-90-R) and a jaw disability checklist. A pilot study, based on 37 new TMD patient records, was conducted to study the pain-related disability and psychological status of TMD patients using this newly developed program. The mean age of the predominantly Chinese population (86.5%) was 32.19 years (range 20-72 years) with a sex distribution of 24 females and 13 males. Most patients (78%) had low disability, with 12 patients having low intensity and 17 patients having high intensity pain. Approximately 73% of the sample population were moderately or severely depressed. Patients that were moderately and severely depressed had significantly higher scores for limitation related to mandibular functioning than normal patients. The three most frequent jaw disabilities were: eating hard foods (84%), yawning (78%) and chewing (65%).
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