[Orofacial dysfunction and posttraumatic stress disorder : A context analysis of soldiers after military deployment]

The Association Between Post-Traumatic Stress Disorder and Temporomandibular Disorders: A Systematic Review

The purpose of this systematic study was to discover a connection between temporomandibular joint disorders and post-traumatic stress disorder. A systematic review of observational studies on post-traumatic stress disorder and the incidence of temporomandibular joint disorders (TMD) was conducted. Electronic searches of PubMed, the Saudi Digital Library, Science Direct, the Virtual Health Library (VHL), Scopus, Web of Science, Sage, EBSCO Information Services, and Ovid were performed. There was a consensus among the reviewing examiners. Only studies with the following Medical Subject Headings (MeSH) terms were included: "Posttraumatic stress disorder" combined with "temporomandibular joint disorder," "myofascial pain," "orofacial pain," "internal derangement," "disc displacement with reduction," or "disc displacement without reduction." Only full-text studies in the English language published between 2010 and June 2020 were considered. Of a total of 381 articles meeting the initial screening criteria, only eight were included in the qualitative analysis. Overall, pain is exacerbated in patients with PTSD; that is, their TMD is heightened in all aspects of pain, chronicity, decreased response to conventional therapies, and the need for more potent treatment options as compared with patients with just TMD. The evidence, albeit weak, obtained from the studies included in this review suggests a relationship between PTSD and TMDs.

[Dental disorders with a psychosocial background]

While the mouth and teeth play a lifelong central role in a person's development and wellbeing, psychosocial aspects of disease and health are still only reluctantly included in dental explanatory models. Only dental anxiety with its disease quality of a specific phobia is generally recognized as a mental disorder requiring intervention. It is interpreted as an emotional reaction to aspects of dental treatment, which results in distress for the affected person and appears to be unreasonably intense given the actual dangers involved. Apart from that, the tendency to provide a somatic explanation for symptoms in the dental context persists. This bears implications for the expectations of those affected as well as for interdisciplinary cooperation. In order to improve interdisciplinary support and mutual understanding, the following article introduces the clinical pictures of craniomandibular dysfunction, bruxism, occlusal dysaesthesia, and somatoform prosthesis intolerance alongside dental anxiety. Psychosocial factors can profoundly influence the development, course, and management of these conditions.

Dental Anxiety and Higher Sensory Processing Sensitivity in a Sample of German Soldiers with Inflammatory Periodontal Disease

(1) Background: Dental anxiety with disease value usually leads to avoidance of dental treatment. For the initial diagnosis of the level of anxiety, questionnaires such as the Hierarchical Anxiety Questionnaire (HAQ) are suitable. The construct of sensory processing sensitivity (SPS) describes a general trait in which people with a higher degree of SPS perceive information more strongly and process it more thoroughly. (2) Methods: This cross-sectional study evaluated the relationship between dental anxiety and higher levels of SPS in 116 soldiers referred with different stages of periodontitis for mandatory dental fitness before military deployment. (3) Results: The proportion of patients with periodontitis in stage III + IV was 39% and in stage I + II was 27%. The mean cumulative values of the questionnaires were 20.9 ± 10.6 for HAQ and 27.7 ± 16.0 for SPS. Eleven moderately anxious patients had a SPS value of 37.4 ± 13.5 and 10 highly anxious patients had a value of 36.3 ± 14.1. Patients diagnosed with stage III + IV periodontitis showed significantly higher values on the SPS subscale Low Sensory Threshold (LST), which describes overstimulation by external sensory stimuli, compared to patients with stage I + II periodontitis. Dental anxiety showed moderately significant correlations with the SPS subscale Ease of Excitation (EOE), which measures emotional reactivity to physiological stimuli. (4) Conclusions: Due to the frequency of dental anxiety and higher sensitivity in patients with severe periodontitis, it is useful to record said frequency.