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Sun R, Zhang S, Si J, Zhang L, Yang H, Ye Z, Xiong X. Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population. J Pain Res 2024; 17:431-439. [PMID: 38328021 PMCID: PMC10848921 DOI: 10.2147/jpr.s449377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
Background Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse. Objective This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population. Methods A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history. Results A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P<0.01). The behaviors most strongly associated with PT were "Hold or jut jaw forward/to the side" (OR:4.478), "Hold, tighten or tense muscles without clench" (OR:3.343) and "Hold jaw in rigid or tense position" (OR:3.209). Conclusion The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.
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Affiliation(s)
- Ruonan Sun
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Shuyuan Zhang
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jiarui Si
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Liming Zhang
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Haolun Yang
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zheng Ye
- West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xin Xiong
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Zhu R, Zhang L, Zheng YH, Zhang ZH, Zhang LM, Yang HL, Yue Y, Xiong X. Association between Stigma and Pain in Patients with Temporomandibular Disorders. Int J Clin Pract 2022; 2022:2803540. [PMID: 36212051 PMCID: PMC9519306 DOI: 10.1155/2022/2803540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study aims to explore the association between stigma and pain in patients with temporomandibular disorders (TMDs). METHODS Two hundred and twenty-five patients with TMDs were recruited, and they completed the questionnaires including the Visual Analogue Scale of Pain (VAS), Generalized Anxiety Disorder 7-Item (GAD-7), the Patient Health Questionnaire 9-item (PHQ-9), Jaw Functional Limitation Scale 8-item (JFLS-8), the Stigma Scale for Chronic Illness 8-item (SSCI-8), and other demographic and disease-related information. The total score of SSCI-8 indicated overall stigma, which could be classified into 2 subdomains, felt stigma and enacted stigma, according to their representative items, respectively. Then, the patients were divided into 2 groups in each subdomain of stigma according to their scores: stigma group (score ≥ 1) and no stigma group (score = 0). RESULTS Patients with overall stigma and enacted stigma presented significantly higher scores in VAS, GAD-7, PHQ-9, and JFLS-8 than those without overall stigma and those without enacted stigma, respectively. Significant differences between patients with and without felt stigma were only observed in GAD-7, PHQ-9, and JFLS-8. Patients with overall stigma and enacted stigma mainly suffered from pain-related TMDs (PTs) and combined TMDs (CTs). Overall stigma and enacted stigma rather than felt stigma were significantly associated with both PTs and CTs. Stigma, including overall stigma, enacted stigma, and felt stigma, was more associated with anxiety and depression and less related to jaw functional limitation of the patients with TMDs. CONCLUSION Stigma, specifically enacted stigma, was correlated to pain in patients with TMDs. Stigma was more related to psychological problems than jaw functional limitation.
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Affiliation(s)
- Rui Zhu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Li Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yun-Hao Zheng
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zi-Han Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Li-Ming Zhang
- Rehabilitation Medicine Center, Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao-Lun Yang
- Rehabilitation Medicine Center, Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Yue
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xin Xiong
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Weise C, Schulz MC, Frank K, Cetindis M, Koos B, Weise H. Acute arthritis of the right temporomandibular joint due to Lyme disease: a case report and literature review. BMC Oral Health 2021; 21:400. [PMID: 34399746 PMCID: PMC8365916 DOI: 10.1186/s12903-021-01744-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022] Open
Abstract
Background Lyme disease is the most frequent tick-borne infectious disease in Europe. It often presents with a wide variety of symptoms. For this reason, affection of the temporomandibular joint (TMJ) caused by Lyme disease (LD) can be misdiagnosed as a common temporomandibular disorder (TMD). Case presentation The purpose of this case report of a 25-year-old woman presenting to the Departments of Orthodontics and Oral and Maxillofacial Surgery with extensive symptoms of temporomandibular disorder is to illustrate the delayed diagnosis of Lyme disease which was only made after extensive therapy of the temporomandibular joint. The specialist literature only reports a few cases of patients suffering from Lyme disease with TMJ manifestations. Conclusion This case report and the relevant literature review aim to emphasize the importance of accurate request of medical history and differential diagnosis of acute TMJ arthritis and arthralgia. Early interdisciplinary diagnosis of Lyme disease and early antibiotic therapy are essential to avoid misdiagnosis and unnecessary, sometimes invasive, therapies.
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Affiliation(s)
- Christina Weise
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Matthias C Schulz
- Department of Oral and Maxillofacial Surgery, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School , University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany.
| | - Karin Frank
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Marcel Cetindis
- Department of Oral and Maxillofacial Surgery, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School , University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Bernd Koos
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Hannes Weise
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany.,Department of Oral and Maxillofacial Surgery, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School , University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
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Kuć J, Szarejko KD, Gołębiewska M. Evaluation of Soft Tissue Mobilization in Patients with Temporomandibular Disorder-Myofascial Pain with Referral. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9576. [PMID: 33371343 PMCID: PMC7767373 DOI: 10.3390/ijerph17249576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 01/08/2023]
Abstract
The aim of the study was functional evaluation of soft tissue mobilization in patients with temporomandibular disorder-myofascial pain with referral. The study group consisted of 50 individuals-37 females and 13 males. The average age was 23.36 ± 2.14 years. All subjects were diagnosed with myofascial pain with referral (diagnostic criteria for temporomandibular disorders). Soft tissue mobilization was applied three times. Electromyography of selected masticatory muscles was performed six times-before and after the treatment. After each mobilization, a decreasing tendency of muscular activity was observed in the entire study group. The Friedman test indicated that mobilization altered the activity of the right temporal muscle (p = 0.00010), both masseters (p = 0.0000), right sternocleidomastoid (p = 0.00251), left sternocleidomastoid (p = 0.00033), and right and left digastric muscles (p = 0.00045 and p = 0.00000, respectively). With respect to symmetry a statistically significant difference was noted in the case of the sternocleidomastoid muscles (p = 0.00729). In conclusion, soft tissue mobilization seems to be effective in the relaxation of masticatory muscles in patients with temporomandibular disorders. Our findings proved that soft tissue mobilization does not improve the symmetry and synergy of the masticatory muscles limited by dental occlusion.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 15-276 Bialystok, Poland
| | | | - Maria Gołębiewska
- Department of Dental Techniques, Medical University of Bialystok, 15-269 Bialystok, Poland;
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Self-Perceived Dentists' Knowledge of Temporomandibular Disorders in Krakow: A Pilot Study. Pain Res Manag 2020; 2020:9531806. [PMID: 32566064 PMCID: PMC7273367 DOI: 10.1155/2020/9531806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/02/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
Introduction The most common nondental orofacial pain conditions are temporomandibular disorders (TMDs). TMD basic examination and clinical management are included in a curriculum of each dentistry programme taught in Poland, but it is not clear how the dentists cope with diagnosis and possible treatment in their routine dental practices. The objective of the present study was to assess a level of self-perceived knowledge of TMD amongst dentists in Poland. Materials and methods. The participants, of whom all studied and graduated from a Polish university, were randomly selected from dental offices in Krakow (Poland). The selected dentists were administered an anonymous questionnaire, which contained questions measuring self-assessment of knowledge of TMD diagnosis and therapy and assessing knowledge of ethology and TMD symptoms. Results Only 6.5% of the participants identified their TMD knowledge as very good, 32.3% assessed it as good, 39.3% thought it was sufficient, 20.4% as insufficient, and 1.49% considered it as poor. 9.4% of all participants have attempted to diagnose and treat TMD patients very often, 26.4% declared performing it often, 45.8% rarely, and 18.4% had never made such an attempt. There was a significant relationship between the dentists' knowledge and their attempts at diagnosing and treating TMD patients (p < 0.05). Conclusion The level of TMD knowledge amongst the Polish dentists is still insufficient. Raising its level would considerably help the dentists to refer their patients to right specialists for a diagnosis and TMD treatment and/or interdisciplinary management of TMD patients.
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Udziela S, Biesiada G, Osiewicz M, Michalak M, Stażyk K, Garlicki A, Czepiel J. Musculoskeletal manifestations of Lyme borreliosis - a review. Arch Med Sci 2020; 18:726-731. [PMID: 35591816 PMCID: PMC9102650 DOI: 10.5114/aoms.2020.96458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/23/2020] [Indexed: 12/03/2022] Open
Abstract
Lyme borreliosis (LB) is a zoonotic disease caused by Gram-negative bacteria Borrelia burgdorferi sensu lato. The majority of reported cases of LB originate in the northern hemisphere, mostly in the US and Europe. One of the typical manifestations of LB are musculoskeletal symptoms; they may appear in any of the three LB stages. The diagnosis is based on clinical manifestations and confirmed by serological tests. One course of antibiotic therapy is sufficient for LB to dissipate in most cases, although for some patients, the symptoms subside gradually even after completion of therapy. Patients who have been demonstrated to have specific antibodies but are symptomless should not be treated. In instances where the advised treatment proved to be unsuccessful, patients should be referred to rheumatologist for additional diagnostics. The goal of this review is to update physicians on current scientific knowledge on musculoskeletal manifestations of LB.
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Affiliation(s)
| | - Grażyna Biesiada
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Michalak
- Students’ Scientific Society Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Stażyk
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Aleksander Garlicki
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
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