The Role of Stress in the Etiology of Oral Parafunction and Myofascial Pain

Background Determining the somatosensory and psychosocial profile of patients with painful temporomandibular joint (TMJ) clicking can help to understand the pain mechanisms in cases of TMJ clicking. Objective To characterise the somatosensory and psychosocial profile of patients with painful TMJ clicking when compared to patients with painless TMJ clicking and healthy control group. Methods Somatosensory and psychosocial functions were assessed in 90 individuals: patients with painful TMJ clicking (n = 30); patients with painless TMJ clicking (n = 30); and healthy controls (n = 30). Somatosensory profile included: mechanical pain threshold (MPT); wind‐up ratio (WUR); pressure pain threshold (PPT); and conditioned pain modulation (CPM). Psychosocial profile included some questionnaires: Pittsburgh Sleep Quality Index (PSQI); Pain Vigilance‐Awareness Questionnaire (PVAQ); Pain Catastrophizing Scale (PCS); Tampa Scale for Kinesiophobia (TSK); Perceived Stress (PSS); and State‐Trait Anxiety Inventory (STAI). All variables were compared among all groups. Results Higher values of MPT and WUR; lower PPT; less efficient CPM; and higher scores of PSQI, PVAQ, PCS, and TSK were found in patients with painful TMJ clicking when compared to the other two groups (P < .001). Patients with painless TMJ clicking showed lower PPT and higher scores of PVAQ and TKS than the healthy control group. PSS and STAI data had no differences. Conclusion Patients with painful TMJ clicking had abnormalities in the somatosensory profile, with a significant somatosensory gain of function (more sensitive) to mechanical pain tests and less efficient CPM. Poor sleep quality along with higher levels of hypervigilance, pain catastrophising, and kinesiophobia were features of psychosocial profile of these patients.

Section: Discussioncontrasting

confidence: 70%

Somatosensory and psychosocial profile of patients with painful temporomandibular joint clicking

Poluha

Canales

Bonjardim

et al. 2020

“…Oral behaviours were also found to be associated with pain in the neck and shoulder area, which at first sight seems unexpected. However, it has been found that the report of oral behaviours is confounded by other variables, as oral behaviours appear to be associated with stress, headache and TMD pain, while at the same time TMD pain and stress being associated with headache and neck complaints . In line with this is the finding that stress, neck/shoulder pain and headaches are all associated with each other .…”

Section: Discussionmentioning

confidence: 84%

Temporomandibular disorders, pain in the neck and shoulder area, and headache among musicians

Selms

Wiegers

Meer

et al. 2019

Background Uncertainties still exist about the role of playing musical instruments on the report of musculoskeletal complaints and headache. Objectives To evaluate the prevalence of and risk indicators for symptoms of temporomandibular disorders, pain in the neck or shoulder, and headache among musicians. Methods A questionnaire was distributed among 50 Dutch music ensembles. Results The questionnaire was completed by 1470 musicians (response rate 77.0%). Of these, 371 musicians were categorised as woodwind players, 300 as brass players, 276 as upper strings players, 306 as vocalists and 208 as controls; nine musicians had not noted their main instrument. The mean age was 41.6 years (standard deviation [SD] 17.2), and 46.5% were male. Irrespective of instrumentalist group, 18.3% of the musicians reported TMD pain, 52.5% reported pain in the neck and shoulder area, and 42.5% reported headache. Of the functional complaints, 18.3% of the musicians reported TMJ sounds, whereas a jaw lock or catch on opening or on closing was reported by 7.1% and 2.4%, respectively. TMD pain was associated with playing a woodwind instrument, whereas pain in the neck and shoulder was associated with playing the violin or viola. For each complaint, oral behaviours were found as risk indicator, supplemented by specific risk indicators for the various complaints. Conclusions The current finding that pain‐related symptoms varied widely between instrumentalist groups seems to reflect the impact of different instrument playing techniques. Playing a musical instrument appears not the primary aetiologic factor in precipitating a functional temporomandibular joint problem.

“…Recent evidence indicates that parafunctional behaviours are a significant predictor for first lifetime temporomandibular disorder onset . Suggested mechanisms by which frequent parafunctional behaviours operate include increased muscular tension in the masticatory muscles and increased load on the temporomandibular joints as well as central mechanisms …”

Section: Introductionmentioning

confidence: 99%

Cultural equivalence, reliability and utility of the Portuguese version of the Oral Behaviours Checklist

Barbosa

Manso

Reis

et al. 2018

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