The Longitudinal Relationship between Jaw Catching/Locking and Pain

Temporomandibular disorder pain is associated with increased sick leave and reduced health related quality of life

BACKGROUND

Temporomandibular disorders (TMD) are the most common reason for chronic pain in the orofacial area and significantly impact the lives of those affected. The role of lifestyle factors in TMD, however, remains less explored. This cohort study aims to estimate TMD prevalence by addressing potential selection biases and to evaluate the association between TMD and lifestyle factors with a specific focus on sick leave and health related quality of life.

METHODS

By linking data on TMD in the general population in Västerbotten, northern Sweden (n = 180,000) to health survey data (n = 120,000), information on sociodemographic factors and quality of life was available for 52,961 individuals (50.6% women) with a mean age of 53 years. We applied inverse probability weighting to adjust for selection bias and Poisson regression to explore associations with TMD.

RESULTS

TMD prevalence was 9.2% during the study period, being higher in women (12.9%) than men (5.4%). Weighting for varying visiting frequencies did not affect TMD prevalence (average difference 0.4% points). Individuals with TMD, especially women, reported more sick leave and use of pain medication, with a significant association between TMD and increased sick leave (prevalence ratio 1.89, 95% CI: 1.78-2.01) among both women and men. In addition, TMD was associated with a lower health related quality of life (p < 0.001).

CONCLUSION

The association of TMD with sick leave highlights the condition's profound impact on the lives of affected individuals. These findings underscore the influence of TMD on work life and the burden of TMD on the societal level.

SIGNIFICANCE STATEMENT

The findings provide insight into how TMD affect individuals, by incorporating lifestyle factors, social determinants and the impact of sick leave at a population level. By incorporating these areas into the study of TMD, we can deepen our understanding of how TMD affects individuals' lives. This approach may also create opportunities to develop more comprehensive strategies to address TMD, focusing on broader implications beyond the clinical symptoms.

Clinical profile in relation to age and gender of patients with temporomandibular disorders: a retrospective study

BACKGROUND

The present study is to evaluate the clinical characteristics of patients with temporomandibular disorders (TMD).

METHODS

A total of 3362 TMD patients were included. Each participant had complete medical records according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The clinical characteristics including symptoms and signs in relation to age and gender were analyzed.

RESULTS

The mean age of the patients seeking care was 29.89 ± 13.73Y, and 68.6% of patients were aged 16-35 years. The female-to-male ratio of patients was 2.2: 1, and the average age of males was significantly lower than that of females. The prevalence of clicking symptoms decreased with age, while the prevalence of pain symptoms and limitations in jaw movement increased with age. Females were more likely to have limitations in jaw movement than males. Among the patients with pain, the average visual analogue scale (VAS) was 2.96 ± 1.23. The average VAS score of acute TMD patients (≤ 3 months) was significantly higher than that of chronic TMD patients (> 3 months).

CONCLUSIONS

The majority of TMD patients seeking care were young people. The number and average age of female patients was higher than the males. Female patients were more likely to have limitations in jaw movement than males.

Comparative study of arthrocentesis with concentric-needle cannula with classic concentric needle: A randomized single-blind controlled clinical trial

This study aimed to assess and compare the efficacy of two distinct single-puncture techniques in temporomandibular joint (TMJ) arthrocentesis for managing disk displacement without reduction (DDwoR). Sixty patients with DDwoR were randomly and blindly assigned to two treatment groups (n = 30 each): group 1 - TMJ arthrocentesis with the classic concentric needle; and group 2 - TMJ arthrocentesis with the concentric needle-cannula system. The following variables were recorded and compared across the groups: patient's pain perception (visual analog scale - VAS, 0-10); maximal interincisal distance (MID, mm); facial edema (FE, presence or absence); and operation duration (OP, minutes). Patients in group 2 presented significantly lower values of VAS score and presence of FE (p < 0.05) when examining the data at 24 and 48 h after the arthrocentesis. They also showed an increase in MID values (p = 0.024) after 6 months. With regard to OP, no significant difference was observed between the groups. Performing a single-puncture TMJ arthrocentesis using a concentric needle-cannula system significantly reduced the patients' pain perception, and mitigated the presence of facial edema during the immediate postoperative period (at 24 and 48 h). Furthermore, it resulted in a notable increase in the MID after 6 months.

Whiplash trauma did not predict jaw pain after 2 years: an explorative study

OBJECTIVES

To explore predictive factors for the development and maintenance of jaw pain over a 2-year period.

METHODS

One hundred nineteen cases (73 women) and 104 controls (59 women), mean age 34.9 years (SD 13.9), attended baseline and 2-year follow-up examinations. The whiplash cases visited the emergency department at Umeå University Hospital, Sweden, with neck pain within 72 h following a car accident, and baseline questionnaires were answered within a month after trauma. Controls were recruited via advertising. Inclusion criteria were age 18-70 years, living in Umeå municipality and Swedish speaking. The exclusion criterion was neck fracture for cases and a previous neck trauma for controls. Validated questionnaires recommended in the standardized Research Diagnostic Criteria for temporomandibular disorders were used. Jaw pain was assessed by two validated screening questions answered with "yes" or "no." A logistic regression analysis was used to predict the outcome variable jaw pain (yes/no) after 2 years.

RESULTS

Whiplash trauma did not increase the odds of development of jaw pain over a 2-year period (OR 1.97, 95% CI 0.53-7.38). However, non-specific physical symptoms (OR 8.56, 95% CI 1.08-67.67) and female gender (OR 4.89, 95% CI 1.09-22.02) did increase the odds for jaw pain after 2 years.

CONCLUSION

The development and maintenance of jaw pain after whiplash trauma are primarily not related to the trauma itself, but more associated with physical symptoms.

CLINICAL RELEVANCE

The development of jaw pain in connection with a whiplash trauma needs to be seen in a biopsychosocial perspective, and early assessment is recommended.

Sociodemographic Profile: A Forgotten Factor in Temporomandibular Disorders? A Scoping Review

The literature on Temporomandibular Disorders (TMD) incidence commonly reports sociodemographic factors such as gender and age. However, the role and prevalence of other sociodemographic factors in TMD are not well defined. Therefore, this scoping review aimed to report the prevalence of sociodemographic factors in TMD patients. A systematic search was conducted in the PubMed and Web of Science databases to identify clinical trials in adult populations, using the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD) and reporting sociodemographic data in TMD patients. Twenty-seven studies meeting the criteria were included in this review. The most commonly reported sociodemographic factors assessed in the included studies were age, race, education, job, income, and marital status. TMD prevalence was observed to be higher among younger and divorced individuals among the included studies. However, conflicting results were found for education level, and employment was not considered a risk factor for TMD. Although this review has methodological limitations, it suggests an association between TMD incidence and certain sociodemographic factors; nevertheless, further studies are needed to establish this relationship more conclusively.