| 1. |
- Sharma, Sonia, et al.
(författare)
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Pain Sensitivity Modifies Risk of Injury-Related Temporomandibular Disorder
- 2020
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Ingår i: Journal of Dental Research. - : Sage Publications. - 0022-0345 .- 1544-0591. ; 99:5, s. 530-536
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates contributions of jaw injury and experimental pain sensitivity to risk of developing painful temporomandibular disorder (TMD). Data were from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) nested case-control study of incident painful TMD. Injury and subsequent onset of painful TMD were monitored prospectively for ≤5 y in a community-based sample of 409 US adults who did not have TMD when enrolled. At baseline, thermal-pressure and pinprick pain sensitivity, as potential effect modifiers, were measured using quantitative sensory testing. During follow-up, jaw injury from any of 9 types of potentially traumatic events was determined using quarterly (3-monthly) health update questionnaires. Study examiners classified incident painful TMD, yielding 233 incident cases and 176 matched controls. Logistic regression models, estimated incidence odds ratios (IORs), and 95% confidence limits (CLs) were used for the association between injury and subsequent onset of painful TMD. During follow-up, 38.2% of incident cases and 13.1% of controls reported 1 or more injuries that were 4 times as likely to be intrinsic (i.e., sustained mouth opening or yawning) as extrinsic (e.g., dental visits, whiplash). Injuries due to extrinsic events (IOR = 7.6; 95% CL, 1.6-36.2), sustained opening (IOR = 5.4; 95% CL, 2.4-12.2), and yawning (IOR = 3.4; 95% CL, 1.6-7.3) were associated with increased TMD incidence. Both a single injury (IOR = 6.0; 95% CL, 2.9-12.4) and multiple injuries (IOR = 9.4; 95% CL, 3.4,25.6) predicted greater incidence of painful TMD than events perceived as noninjurious (IOR = 1.9; 95% CL, 1.1-3.4). Injury-associated risk of painful TMD was elevated in people with high sensitivity to heat pain (IOR = 7.4; 95% CL, 3.1-18.0) compared to people with low sensitivity to heat pain (IOR = 3.9; 95% CL, 1.7-8.4). Jaw injury was strongly associated with elevated painful TMD risk, and the risk was amplified in subjects who had enhanced sensitivity to heat pain at enrollment. Commonly occurring but seemingly innocuous events, such as yawning injury, should not be overlooked when judging prognostic importance of jaw injury.
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| 2. |
- Al-Harthy, Mohammad, et al.
(författare)
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Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain
- 2017
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 44:6, s. 415-425
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Tidskriftsartikel (refereegranskat)abstract
- Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. Self-report questionnaires assessed back, chest, stomach and head pain for prevalence, pain intensity and interference with daily activities. Logistic regression was used for binary variables, and ancova was used for parametric data analysis, adjusting for age and education. Back pain was the only comorbid condition with a different prevalence across cultures; Swedes reported a lower prevalence compared to Saudis (P < 001). Saudis reported higher prevalence of work reduced >50% due to back pain compared to Italians or Swedes (P < 001). Headache was the most common comorbid condition in all three cultures. The total number of comorbid conditions did not differ cross-culturally but were reported more by TMD-pain cases than TMD-free controls (P < 001). For both back and head pain, higher average pain intensities (P < 001) and interference with daily activities (P < 001) were reported by TMD-pain cases, compared to TMD-free controls. Among TMD-pain cases, Italians reported the highest pain-related disability (P < 001). Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation.
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| 3. |
- Anderson, GC, et al.
(författare)
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TMD Pain, Physical, and Emotional Functioning Related to Headache Frequency
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Temporormandibular disorders (TMD) and tension-type headaches (TTHA) share many signs and symptom and several studies have demonstrated an overlap between these conditions. Objectives: This study investigated the relationship of headache frequency with patient-reported TMD pain intensity, physical functioning, and emotional functioning in subjects with TTHA attributed to TMD. Methods: The RDC/TMD Validation Project, as a subset of 633 TMD cases, identified 153 subjects with concurrent TMD pain diagnoses (RDC/TMD myofascial pain or TMJ arthralgia) and TTHA (International Classification of Headache Disorders-II / ICHD-II) presenting in the temporal region. These subjects also demonstrated pain similar to their headache on provocation by palpation of the temporalis muscle. The headache diagnoses were sub-divided into infrequent episodic, frequent episodic, and chronic TTHA according to the ICHD-II. Outcomes of the study were self-report measures of jaw pain intensity (average pain intensity), physical functioning (Jaw Function Limitation Scale/JFLS, Ohrbach et al, 2008; Graded Chronic Pain Scale/GCPS, von Korff et al, 1992; Short Form -12/SF-12, Ware et al, 1996) and emotional functioning (depression, somatization, anxiety as measured by the Symptom Checklist-90/SCL-90). Differences in outcomes among the three headache subgroups were investigated using ANOVA. Results: Pain intensity in the temple and jaw regions was significantly associated with increased frequency of headache (p<0.01). Physical functioning as assessed with the JFLS (p<0.05) and the GCPS (p<0.01) were also significantly associated with headache frequency. Emotional functioning as assessed with the SCL-90 in terms of depression, somatization, and anxiety were all associated with frequency of headache (p<0.05). In general, the more frequent a subject's TTHA the more severe the levels of outcome. Conclusion: TMD pain intensity, physical functioning, and emotional functioning were associated with the frequency of TMD-related tension-type headache.
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| 4. |
- Durham, Justin, et al.
(författare)
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Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 51:5, s. 785-794
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.Results: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment.Conclusion: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.
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| 5. |
- Durham, Justin, et al.
(författare)
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Self-management programmes in temporomandibular disorders : results from an international Delphi process
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:12, s. 929-936
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Forskningsöversikt (refereegranskat)abstract
- Self-management (SM) programmes are commonly used for initial treatment of patients with temporomandibular disorders (TMD). The programmes described in the literature, however, vary widely with no consistency in terminology used, components of care or their definitions. The aims of this study were therefore to construct an operationalised definition of self-management appropriate for the treatment of patients with TMD, identify the components of that self-management currently being used and create sufficiently clear and non-overlapping standardised definitions for each of those components. A four-round Delphi process with eleven international experts in the field of TMD was conducted to achieve these aims. In the first round, the participants agreed upon six principal concepts of self-management. In the remaining three rounds, consensus was achieved upon the definition and the six components of self-management. The main components identified and agreed upon by the participants to constitute the core of a SM programme for TMD were as follows: education; jaw exercises; massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. This Delphi process has established the principal concepts of self-management, and a standardised definition has been agreed with the following components for use in clinical practice: education; self-exercise; self-massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. The consensus-derived concepts, definitions and components of SM offer a starting point for further research to advance the evidence base for, and clinical utility of, TMD SM.
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| 6. |
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| 7. |
- Larsson, Pernilla, et al.
(författare)
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Reliability and validity of a Swedish version of the Oral Health Impact Profile (OHIP-S)
- 2004
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 147-152
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to translate the Oral Health Impact Profile (OHIP) into Swedish and evaluate the reliability and validity of the Swedish version (OHIP-S). The CHIP is a 49-item, self-administered questionnaire divided into 7 different subscales. The original version in English was translated into Swedish, accompanied by back-translation into English, after which the Swedish version was revised. A total of 145 consecutive patients participated and answered a questionnaire. The patients comprised five clinically separate groups: temporomandibular dysfunction (TMD) (n = 30), Primary Sjogren's Syndrome (SS) (n = 30), burning sensation and pain in the oral mucosa (oral mucosal pain, OMP) (n = 28), skeletal malocclusion (malocclusion) (n = 2 7), and healthy dental recall patients (Controls) (n = 30). The TMD group and the control group participated in a test-retest procedure. The internal reliability of each subscale was calculated with Cronbach's alpha and found to be high and to range from 0.83-0.91. The stability (test-retest) of the instrument, calculated using the intraclass correlation coefficient, ranged from 0.87 to 0.98. The construct validity of OHIP-S was compared with subscales of the Symptom Check List (SCL-90) (rho 0.65) and the jaw Function Limitation Scale JFLS) (rho 0.76) and analyzed with Spearman's correlation coefficient. Convergent validity was evaluated by comparing CHIP with self-reported health using Spearman's correlation coefficient and was found to be acceptable (rho 0.61). In the evaluation of the discriminative ability of the instrument, significant differences were found in the total OHIP-S score between the controls and the other four groups (P < 0.001). We conclude that the reliability and validity of OHIP-S is excellent. The instrument can be recommended for assessing the impact of oral health on masticatory ability and psychosocial function.
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| 8. |
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| 9. |
- Michelotti, A, et al.
(författare)
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Next steps in development of the diagnostic criteria for temporomandibular disorders (DC/TMD) : Recommendations from the International RDC/TMD Consortium Network workshop
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:6, s. 453-467
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Tidskriftsartikel (refereegranskat)abstract
- The development of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) (1) involved expanding the taxonomy for all TMDs (2) in order to propose for future validation DC for empirically supported TMDs that were not part of the DC/ TMD structure. This expanded taxonomy offers an integrated approach to clinical diagnosis and provides a framework for operationalising and testing the proposed taxonomy and diagnostic criteria in future research. During expansion of the taxonomy, researchers identified several challenges in the diagnosis of some disorders, so the International RDC/TMD Consortium Network planned a workshop to discuss criterion improvements for five of the disorders and the biobehavioural domain.
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| 10. |
- Sharma, Sonia, et al.
(författare)
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Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain
- 2020
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 47:1, s. 87-100
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Tidskriftsartikel (refereegranskat)abstract
- Distress, suffering and care-seeking behaviour are characteristics of pain-related disease and illness. Pain that transitions from an acute to a chronic phase carries with it the potential of further effects: these include a worsening of the disease or illness; high-impact chronic pain; and substantial personal, societal and economic burden. The biopsychosocial model directly addresses these multiple processes, yet clinical frameworks supporting this model are not universally implemented. This paper explores barriers to clinical implementation of a full biopsychosocial framework for temporomandibular disorders (TMD) and other oro-facial pain (OFP) conditions. In June 2016, INfORM invited OFP researchers to a workshop designed to optimise the DC/TMD Axis-II. Workshop groups identified five sources of implementation barriers: (1) cultures and societies, (2) levels-of-care settings, (3) health services, (4) cross-cultural validity of self-report instruments and (5) provider and patient health literacy. Three core problems emerged: (A) mental health aspects are seldom fully considered, thus impairing the recognition of illness, (B) training in use of validated multi-axial assessment protocols is under-rated and insufficiently used, and (C) clinical assessment often fails to recognise that sensory and emotional dimensions are fundamental aspects of pain. To improve patient care, these barriers and problems require action. Most importantly, TMD/OFP educators and researchers need to coordinate globally and (i) be educated in the biopsychosocial model, (ii) implement evidence-based biopsychosocial guidelines for assessment and management of OFP conditions at their institutions, (iii) incorporate this model in undergraduate and postgraduate dental curricula and (iv) be responsive to stakeholders, including regulatory authorities and practitioners.
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