Association Between Symptoms of Posttraumatic Stress Disorder and Signs of Temporomandibular Disorders in the General Population

Kindler, Stefan; Schwahn, Christian; Bernhardt, Olaf; Söhnel, Andreas; Mksoud, Maria; Biffar, Reiner; Meyer, Georg; Völzke, Henry; Metelmann, H.‐R.; Grabe, Hans J.

doi:10.11607/ofph.1905

Cited by 16 publications

(19 citation statements)

References 15 publications

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“…The association of Alexithymia with TMD is in line with studies emphasising the relevance of mental disorders for TMD . The associations of Alexithymia in our study defined by the TAS‐20 and particularly of DIF with different pain manifestations were consistent with results from previous studies showing a link between alexithymia and chronic pain.…”

Section: Discussionsupporting

confidence: 92%

Alexithymia and temporomandibular joint and facial pain in the general population

Kindler

Schwahn

Terock

et al. 2018

J of Oral Rehabilitation

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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.

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Section: Discussionsupporting

confidence: 92%

Alexithymia and temporomandibular joint and facial pain in the general population

Kindler

Schwahn

Terock

et al. 2018

J of Oral Rehabilitation

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“…The variation from baseline to follow up of the GCPS was also significantly correlated with CSS but only for those with chronic TMD. Several studies have revealed an association between stress, pain and disability in people with TMDs by identifying stress events as a possible amplifier of TMD symptoms [19,28,64,65]. Even if no causal relation can be drawn, our prospective study provides new insight on the association between stress and chronic facial pain severity by showing that when patients with chronic TMD are exposed to stress, they experience greater pain and pain-related disability.…”

Section: Plos Onementioning

confidence: 79%

“…Case-control studies observed that stress, anxiety, depression and catastrophizing scores were significantly higher in people with TMD than in an asymptomatic population [15,16]. Moreover, people with orofacial pain have reported that stress contributed to the onset, development and maintenance of their pain [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders

Asquini

Bianchi²,

Borromeo³

et al. 2021

PLoS ONE

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This study aimed to understand the impact of COVID-19 distress on psychological status, features of central sensitization and facial pain severity in people with temporomandibular disorders (TMDs). In this prospective cohort study, 45 adults (19 chronic, 26 acute/subacute TMD) were recruited prior to the COVID-19 outbreak. Baseline assessment took place before the outbreak while a follow-up was performed immediately after the lockdown period. Multiple variables were investigated including age, gender, perceived life quality, sleep quality, anxiety and depression, coping strategies, central sensitization, pain intensity, pain-related disability and oral behaviour. COVID Stress Scales (CSS) were applied at follow-up to measure the extent of COVID-related distress. CSS were significantly higher in those with chronic TMDs compared to those with acute/subacute TMDs (p<0.05). In people with chronic TMD, the variation in anxiety and depression from baseline to follow-up was significantly correlated with scores on the CSS (r = 0.72; p = 0.002). Variations of the central sensitization inventory (r = 0.57; p = 0.020) and graded chronic pain scale (r = 0.59; p = 0.017) were significantly correlated with scores on the CSS. These initial findings indicate that people with chronic TMD were more susceptible to COVID-19 distress with deterioration of psychological status, worsening features of central sensitization and increased chronic facial pain severity. These findings reinforce the role of stress as a possible amplifier of central sensitization, anxiety, depression, chronic pain and pain-related disability in people with TMDs. Trial Registration: ClinicalTrials.gov ID: NCT03990662.

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“…TMD is diagnosed clinically by evaluating its signs and symptoms that are facial pain, headache, pain over the joint, pain which aggravates while opening the mouth, muscle tenderness, pain which is to the angle of the lower jaw and cervical muscles, restricted mouth opening, deviation of the jaw while opening the mouth, crepitus, and clicking sounds in the joint region [19]. These signs may appear in various combinations and degrees.…”

Section: Resultsmentioning

confidence: 99%

Evaluating the Effect of Complete Dentures on Signs and Symptoms of Temporomandibular Disorders Analyzed by Craniomandibular Index in Completely Edentulous Patients- A Study Protocol

Nimonkar

Godbole

Belkhode

2021

JPRI

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Background: A Temporo-mandibular disorder (TMD) itself is a cumulative terminology used to indicate the situations which entails the pain alone or in association with dysfunction of the Temporomandibular joint (TMJ) with or without involving the associated structures. One of the main cause of developing TMD is the loss of tooth. The completely edentulous patients also have reported high prevalence of TMD as in dentulous patients. Methods: It is a prospective interventional study that will be carried out in three years. The sample size will be those completely edentulous subjects, who has not used dentures for a duration of six months to five years of tooth extraction. Such subjects will then be subjected to anamnestic component of Helkimos Index for screening purpose.110 subjects exhibiting mild to severe signs and symptoms of Temporomandibular disorders will be considered as the study participants for the study. Study participants will be categorized as Group A (study participants having mild symptoms of TMD, n=55) and the second will be Group B (study participaants having severe symptoms of TMD, n=55). The Craniomandibular Index will be used to score the severity of the TMD before denture insertion. The initial recorded score will be then correlated with the score obtained after 3 months of delivery of denture. Descriptive as well as analytical statistics will be performed. The statistical relevance among the Group A and Group B before intervention and after 3months of intervention will be assessed at p<0.05. Discussion: Through the study results we anticipate a fall in CMI score i.e improvement by lowering the intensity of TMD due to intervention by complete dentures in completely edentulous subjects. In case the above Hypothesis is not proved, then prevalence of TMD among patients who are completely edentulous needs to be anticipated with the factors such as anatomical or pathological diversities in TMJ and not to be associated with changes in vertical dimensions because of teeth loss.

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Association Between Symptoms of Posttraumatic Stress Disorder and Signs of Temporomandibular Disorders in the General Population

Abstract: These results should encourage general practitioners and dentists to acknowledge the role of PTSD and traumatic events in the diagnosis and therapy of TMD, especially in a period of international migration and military foreign assignments.

Cited by 16 publications

References 15 publications

Alexithymia and temporomandibular joint and facial pain in the general population

Alexithymia and temporomandibular joint and facial pain in the general population

The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders

Evaluating the Effect of Complete Dentures on Signs and Symptoms of Temporomandibular Disorders Analyzed by Craniomandibular Index in Completely Edentulous Patients- A Study Protocol

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