Identifying potential predictors of pain–related disability in Turkish patients with chronic temporomandibular disorder pain

Abstract

BackgroundThe aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration.MethodsThe Research Diagnostic Criteria of TMD (RDC/TMD) data for Axis I and II were obtained for 104 consecutive patients seeking treatment.Data were analyzed using descriptive statistics, t-test, Mann–Whitney U-test, chi-square test, One-way ANOVA, Kruskal-Wallis test, and binary multiple logistic regression tests. Patients were classified into two groups according to Graded Chronic Pain Scale scores: Grade III and IV were scored for patients with high levels of pain-related disability, whereas Grade I and II were scored for patients with low disability.ResultsMuscle and joint pain were found in 64.9% and 31.8% of the patients, respectively, and 27.3% of the patients suffered from both muscle and joint pain.Psychosocial disability was found in 26% of patients. There were no statistically significant differences among the diagnostic subgroups with regards to the demographic, behavioral, psychological, and psychosocial characteristics. Patients with high levels of pain-related disability had significantly higher depression, somatization, pain intensity and jaw disability scores than those with low levels of pain-related disability.Patients with high levels of pain-related disability were more likely to have higher pain intensity, to report higher somatization symptoms and functional impairment, and were less likely to have joint pain than those with low levels of pain related disability.ConclusionIn conclusion, the Turkish version RDC/TMD, based on a dual axis system, may be used to screen chronic TMD patients at high-risk for pain-related disability who need comprehensive care treatment program.

Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement

“…A possible reason is the high percentage of patients they included in the chronic MP group (64.9 %), the use of other tools to assess disability (jaw disability check list) or the inclusion criteria of more than 6 months for a chronic condition [42]. …”

Validation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD) in patients with painful TMD

“…Temporomandibular disorders (TMD) are now defined as “a group of biopsychosocial illnesses characterized by chronic painful conditions and dysfunction in the muscles of mastication and the temporomandibular joint” [1]. It was reported that 14.9%–17.9% of Chinese people suffered from TMD [2, 3].…”

Aspectos clínicos e psicossociais avaliados por critérios de diagnóstico para disfunção temporomandibular

“…Contradicting the results found, a study showed that patients with high levels of pain-related disability were more likely to have higher pain intensity and to report more symptoms of somatization and mandibular functional disability. Still, they were less likely to have joint pain due to disk displacement than those with low levels of disorderrelated pain 2 .…”

“…Besides being the possible triggers of TMD 2,3,10 , the psychosocial factors are associated to the severity and persistency of clinical symptoms. Those factors influence the patients response to treatment 5,10 , and may be important outcome predictors 18 .…”

“…Temporomandibular disorder (TMD) is a term used to designate several clinical signs and symptoms affecting the muscles of mastication, the temporomandibular joint (TMJ) and structures associated 1,2 . It is considered as a multifactorial disorder 3,4 , presenting as its etiologic factors joint trauma, occlusal discrepancies, joint hypermobility, skeletal problems, parafunctional habits, and psychosocial and behavioral factors 5 .…”