Pain, click and crepitation as factors associated with temporomandibular dysfunction in Parkinson’s disease

Abstract

BACKGROUND AND OBJECTIVES: Parkinson's disease leads to mandibular movements that affect the masticatory cycle and induce orofacial pain, one of the main clinical alterations found in temporomandibular dysfunction. Thus, the present study aimed to analyze the possible factors associated with temporomandibular dysfunction and to verify the frequency of the dysfunction in this population. METHODS: This was a cross-sectional study in which the participants were evaluated using the Diagnostic Criteria for Temporomandibular Dysfunction research, used to classify the temporomandibular dysfunction and to obtain by physical examination and self-report the variables studied. RESULTS: A total of 139 people with Parkinson's disease were evaluated. Of these, 77 met the eligibility criteria, with 70% of the sample being male, with an average age of 62±9 years; Parkinson's disease diagnosis time of 6±4 years and with 71% of the sample in the moderate stage of Parkinson's disease. No significant associations were found between age, gender, time and stage of the disease with temporomandibular dysfunction. Of the variables analyzed, the significant results showed that the presence of pain (OR=10.92, 95% CI=2.25-59.93, p<0.001) has a greater chance of developing temporomandibular dysfunction, crepitation (Kappa=0.34, p<0.004) reflects moderate accuracy in the classification of temporomandibular joint disorder and the click (negative predictive value=77%, p<0.032) increases the probability of having temporomandibular dysfunction.

Sociodemographic profile and stages of Parkinson’s disease associated with predictors of Temporomandibular Disorder

“…It was observed that people that reported this clinical sign were 2.27 times more likely to develop TMD. Such a particularity differs from a recent investigation with a similar sample, which observed that uncomfortable/ non-habitual bite was not related to TMD 16 . It agrees, though, with Trize et al 32 in a study involving 102 people aged 19 to 86 years and using the RDC/TMD to reach a diagnosis; they assessed that discomfort when biting is significantly associated with TMD.…”

“…A recent study pointed out the factors associated with TMD in older adults, namely: being female, having a low income, tinnitus, dizziness, depression, headache, or bruxism, missing teeth, and wearing complete dentures 10 . Moreover, pain, clicking, and crepitation have already been verified as factors associated with TMD in people with PD 16 . Hence, this study aimed to analyze the predictors of TMD in people with PD, verifying their association with sociodemographic aspects and stages of the disease to furnish further information in this field of knowledge.…”

Sociodemographic Profile of Elderly People with Temporomandibular Disorder and Depression in Combination with Parkinson's Disease

“…This predominance was also described in the analysis of motor symptoms of Parkinson's disease carried out at a tertiary hospital in Rio de Janeiro, Brazil, in which there was a proportion of 2.5 men for every 1 woman in a total of 95 patients [22]. Therefore, this explains the contradiction observed from relating only elderly individuals to TMD or to depression, in which the authors highlighted the prevalence of the female sex in the analyses [3,14,[23][24][25].…”

“…including PD [3,4]. Moreover, in a study conducted by Magalhães et al [26], in which social classes were analyzed as risk factors for TMD, it was observed that the individuals that expressed more symptoms belonged to classes D and E.…”

“…PD is associated with the slow loss of dopaminergic neurons, which causes a reduction in voluntary movements, giving rise to motor symptoms, such as resting tremors, bradykinesia, muscular rigidity, and postural instability [2]. Its systemic influences can generate facial manifestations, promoting undesirable jaw movements, the absence of certain facial expressions, and orofacial tremors, sometimes resulting in pain, a significant characteristic for diagnosing temporomandibular disorder (TMD) [3].…”