Smiling, Yawning, Jaw Functional Limitations and Oral Behaviors With Respect to General Health Status in Patients With Temporomandibular Disorder—Myofascial Pain With Referral

Abstract

Background: The temporomandibular joint is the one of the most important joints in the human body. It enables numerous orofacial functions such as mastication, swallowing, breathing, speech, emotional communication, and facial expressions. The aim of the study was to evaluate the prevalence of jaw functional limitations and oral behaviors with respect to general health status in patients with temporomandibular joint disorders—myofascial pain with referral.Materials and methods: The study group consisted of 50 individuals (37 females and 13 males) with complete natural dentition. The average age was 23.36 years with ± 0.30 as a standard error. All subjects underwent clinical examination and were diagnosed with myofascial pain with referral according to the Diagnostic Criteria for Temporomandibular Disorders. The survey was conducted in connection with the Jaw Functional Limitation Scale-8 (JFLS-8), Jaw Functional Limitation Scale-20 (JFLS-20), Patient Health Questionnaire-4 (PHQ-4), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 (PHQ-15), and Oral Behaviors Checklist (OBC).Results: The most common functional problems in the entire study group were chewing tough food and yawning. In terms of gender, statistically significant differences were noted for chewing tough food and smiling (p = 0.015451; p = 0.035978, respectively). With respect to Bonferroni correction and Benjamini-Hochberg procedure, the observed differences were not statistically significant. There were no statistically considerable differences in mastication, mandibular mobility, verbal and emotional communication, or global limitations (p > 0.05). Over half (56%) of the respondents had depression of varying severity. Somatic symptoms of different severity were found in 78% of the patients, and 44% of the respondents declared anxiety disorders. The score of the Oral Behavior Checklist (OBC = 27.18) highlighted a high tendency for developing craniomandibular disorders.Conclusion: Patients with myofascial pain with referral, demonstrated a disturbed biopsychosocial profile. The restrictions in yawning and smiling as well as limitations in mastication, mobility, verbal and emotional communication, and global limitations appear to be significant predictors of craniomandibular dysfunction. Depression, stress, and somatic disorders are important factors predisposing patients to the occurrence of myofascial pain with referral. The progression of oral behaviors may indicate the role of somatosensory amplification.

Impact of different types of temporomandibular disorders on jaw functional limitation and psychological distress in orthodontic patients

“…As TMDs clearly affected jaw function in orthodontic patients, the first null hypothesis of this study was rejected. The mean scores of JLFS‐8 in PT patients were close to a previous study involving 50 patients with myofascial pain (mean JLFS‐8 score = 12.74 ± 12.48) 36 . Likewise, there are some studies showing PT patients have more severe mandibular movement limitation, 16,37 which is consistent with our conclusion.…”

Mastication and mobility limitations, sex differences, and biopsychosocial predictors of jaw functional limitations in Chinese patients with temporomandibular disorder

“…found that healthy individuals had higher incisor biting symmetry in muscle organization (P < 0.03) than did patients with TMD. We found fewer verbal and emotional communication limitations than Kuć et al [20]. who studied 50 Polish patients with TMD who self-administered the JFLS, and reported di culty in smiling and in producing facial expressions and emotions.…”

“…Although not all included psychological risk factors were found to be signi cant predictors of jaw functional limitation in multiple regression analysis, we cannot ignore the potential impact of these factors on jaw function. Kuć et al [20] constructed a multiple regression model with the GAD-7 score as the outcome variable and identi ed the PHQ-15 and PHQ-9 scores as signi cant predictors. These studies showed that psychological risk factors, such as depression, anxiety, somatization, sleep quality, and oral behaviors, are interrelated and have a combined in uence on jaw function.…”

Comparative Evaluation of Occlusion before and after Soft Tissue Mobilization in Patients with Temporomandibular Disorder—Myofascial Pain with Referral

“…As a dysfunction of multifactorial nature, myofascial pain with referral is always related with trigger points of the head and neck. This condition reflects a combination of sensory experiences, motor reactions, and autonomic symptoms, including local and referred pain [ 25 , 26 , 27 ].…”

“…Health concerns which could affect the functioning of the masticatory muscles, • Metabolic diseases, • Medications (long-lasting intake in the past and at present). The study group was described in detail in previous publications [25][26][27].…”