Alexithymia and temporomandibular joint and facial pain in the general population

Abstract

Summary Background Associations of alexithymia with temporomandibular pain disorders (TMD), facial pain, head pain and migraine have been described, but the role of the different dimensions of alexithymia in pain development remained incompletely understood. Objectives We sought to investigate the associations of alexithymia and its subfactors with signs of TMD and with facial pain, head pain and migraine in the general population. Methods A total of 1494 subjects from the general population completed the Toronto Alexithymia Scale‐20 (TAS‐20) and underwent a clinical functional examination with palpation of the temporomandibular joint and masticatory muscles. Facial pain, migraine and head pain were defined by questionnaire. A set of logistic regression analyses was applied with adjustment for age, sex, education, number of traumatic events, depressive symptoms and anxiety. Results Alexithymia was associated with TMD joint pain (Odds Ratio 2.63; 95% confidence interval 1.60‐4.32 for 61 TAS‐20 points vs the median of the TAS‐20 score) and with facial pain severity (Odds Ratio 3.22; 95% confidence interval 1.79‐5.79). Differential effects of the subfactors were discovered with difficulties in identifying feelings as main predictor for joint, facial, and head pain, and externally oriented thinking (EOT) as U‐shaped and strongest predictor for migraine. Conclusion Alexithymia was moderately to strongly associated with signs and symptoms of TMD. These results should encourage dental practioners using the TAS‐20 in clinical practice, to screen TMD, facial or head pain patients for alexithymia and could also help treating alexithymic TMD, facial or head pain patients.

Assessment and Brain Training of Patients Experiencing Head and Facial Pain with a Distortion of Orofacial Somatorepresentation: A Narrative Review

“…In this line, it has been observed that the inability to express feelings with mimics may interfere in the ones' own recognition of emotions [92]. A recent study has found a moderate-to-strong association between face and head pain and alexithymic features [101]. Alexithymia is a personality trait based in an intrinsic difficulty in recognizing the emotional components of subjective experiences (emotion recognition and expression) [102].…”

“…Patients with alexithymia suffer from higher psychopathological distress [103], and it is often stated in connection with chronic pain syndromes [104]. Therefore, it seems to be an important contributing factor in the development of a chronic facial pain [101]. Causes of alexithymia are unknown.…”

Evaluation of alexithymia in individuals with chronic pain in a Mexican population: Alexithymia in a Mexican population

“…When there are various areas of pain afflicting one individual, the distress increases and interferes in the identification and description of feelings. 33,34 Therefore, individuals with chronic pain should undergo psychotherapeutic treatment that enable them to break down this vicious circle by improving their ability to detect and distinguish emotions and bodily sensations. 20,35 The importance to consider psychotherapy also relies on the fact alexithymia could result in hypervigilance, increasing somatic sensations and inducing high levels of depression.…”

Are third molars associated with orofacial pain? Findings from the SHIP study

“…Kappa values for detecting tenderness upon palpation of the masticatory muscles and the temporomandibular joint ranged from 0.53 to 0.63. Training of the dentists and consensus discussions occurred before the start of the examinations and were repeated for calibration twice a year during the period of data collection 31 …”