| 1. |
- Bijelic, Tessa, et al.
(författare)
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Expectations and Experiences of Internet-Based Therapy for Adolescents with TMD Pain
- 2022
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Ingår i: JOURNAL OF ORAL & FACIAL PAIN AND HEADACHE. - : QUINTESSENCE PUBLISHING CO INC. - 2333-0384 .- 2333-0376. ; 36:3, s. 237-252
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate expectations and experiences of internet-based therapy (IBT) in adolescents with temporomandibular disorder (TMD) pain. Methods: Seven adolescents were strategically selected for this study. All patients had received IBT for their TMD pain in a previous randomized controlled trial. One-on-one interviews were conducted in a nonclinical setting. The interviews were semi-structured, following an interview guide with six domains. The recorded interviews were transcribed, and a qualitative inductive content analysis was then performed. Results: Content analysis indicated that the expectations of the adolescents and their experiences of IBT as a treatment for TMD pain can be understood in light of three main categories: (1) To become better; (2) An ambivalent experience; and (3) A personal challenge. The adolescents expressed expectations of less TMD pain after treatment, but also of improvement in general well-being and everyday life. Although their experiences of IBT varied, adolescents described having mixed feelings about treatment and feeling that it was personally challenging. Conclusion: Gained understanding of expectations and experiences is a necessary basis for revising the IBT program to meet the demands of adolescents and to improve treatment adherence. Furthermore, the content of the three categories clarifies the values of adolescents, and this understanding can in turn contribute to the development of new patient -centered treatment programs.
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| 2. |
- Christidis, N, et al.
(författare)
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Effectiveness of a prefabricated occlusal appliance in patients with temporomandibular joint pain : a randomized controlled multicenter study
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:2, s. 128-137
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the effectiveness of a prefabricated appliance and compare it to the effectiveness of a stabilization appliance in patients with temporomandibular joint (TMJ) pain. METHODS: This randomized, controlled multicenter study comprised 48 patients diagnosed with TMJ arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders. The effectiveness of a prefabricated appliance (Relax), worn by half of the patients (referred to as the R group), was compared to the effectiveness of a stabilization appliance, worn by the other half of patients (S group). Treatment outcome was assessed according to the recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. To analyze the differences between groups, the chi-square test and the Mann-Whitney U test were used, while the Friedman analysis of variance (ANOVA) on ranks was used for the analyses between baseline data and follow-up measurements, all with a significance level set at P < .05. RESULTS: There were no differences between the groups at baseline. A 30% reduction of pain intensity was reported by 62.5% of the R group and 58.3% of the S group at the 10-week follow-up; 58% and 50.3%, respectively, at the 6-month follow-up; and 41.7% in both groups at 12 months. At the 12-month follow-up, pain intensity had decreased and physical function had improved in both groups (P < .005 and P < .016, respectively), without significant group differences. Emotional function (depression and nonspecific physical symptoms) did not change. Overall improvement of "better" to "symptom-free" was observed in 67% of the R group and 58% of the S group. No side effects occurred. CONCLUSION: The effectiveness of the prefabricated appliance seems to be similar to that of the stabilization appliance in alleviating TMJ pain. Since the prefabricated appliance requires only one visit for construction, it is convenient for both the general practitioner and for the patient
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| 3. |
- Dawson, Andreas, et al.
(författare)
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Effect of experimental tooth clenching on the release of β-endorphin
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:2, s. 159-164
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate the association between experimental tooth clenching and the release of β-endorphin in patients with myofascial temporomandibular disorders (M-TMD) and healthy subjects. METHODS: Fifteen M-TMD patients and 15 healthy subjects were included and assigned an experimental tooth-clenching task. Venous blood was collected and pain intensity was noted on a visual analog scale. The masseter pressure pain threshold (PPT) was assessed 2 hours before the clenching task and immediately after. A mixed-model analysis of variance was used for statistical analyses. RESULTS: Significant main effects for time and group were observed for pain intensity and PPT, with significantly lower mean values of pain intensity (P < .001) and PPT (P < .01) after the clenching task compared with baseline. M-TMD patients had significantly higher pain intensity (P < .001) and significantly lower PPT (P < .05) than healthy subjects. No significant time or group effects were observed for the level of β-endorphin. Neither pain intensity nor PPT correlated significantly with β-endorphin levels. CONCLUSION: This experimental tooth-clenching task was not associated with significant alterations in β-endorphin levels over time, but with mechanical hyperalgesia and low to moderate levels of pain in healthy subjects and M-TMD patients, respectively. More research is required to understand the role of the β-endorphinergic system in the etiology of M-TMD
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| 4. |
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| 5. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Fear of Movement and Catastrophizing in Participants with Temporomandibular Disorders
- 2022
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 36:1, s. 59-66
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess differences in catastrophizing and kinesiophobia in relation to areas of pain and somatic symptoms among participants with temporomandibular disorders (TMDs) and controls. Methods: In total, 401 participants (333 women, 68 men, mean age: 45.8 years) in the TMJ Impact Project were examined in accordance with the Diagnostic Criteria for TMD, including clinical examination (Axis I) and psychosocial assessment (Axis II) augmented with imaging of the temporomandibular joint (TMJ). Of these, 218 participants had a painful TMD pain diagnosis, 63 had a nonpainful TMD diagnosis, and 111 had no TMD. Nine participants had missing data. Participants completed the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Areas of Pain figure, and the Patient Health Questionnaire-15 for assessing somatic symptoms. Results: Compared to controls, participants with TMD pain showed higher levels of catastrophizing (P = .017), kinesiophobia (P < .001), areas of pain (P < .001), and somatic symptoms (P < .001). Participants with nonpainful TMD showed a higher level of kinesiophobia (P < .001) than controls. There was a positive correlation between catastrophizing and kinesiophobia for participants with TMD pain (r = 0.33, P < .001) and nonpainful TMD (r = 0.42, P < .001). Discussion: The results suggest more fear of movement, as well as an association between catastrophizing and fear of movement, in participants with TMD pain and in participants with nonpainful TMD compared to controls. Assessment and management of fear of movement as well as catastrophizing may be useful as part of individualized treatment strategies for patients with TMD.
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| 6. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Impact of Catastrophizing in Patients with Temporomandibular Disorders : A Systematic Review
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 34:4, s. 379-397B
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Forskningsöversikt (refereegranskat)abstract
- Aims: To assess the prevalence of catastrophizing in patients with temporomandibular disorders (TMD) and the possible associations between catastrophizing and treatment outcome. Methods: This review was registered in the Prospero database (CRD42018114233). Electronic searches were performed in PubMed, Scopus, and PsycINFO from the inception of each database up to October 26, 2018, and were combined with a hand search. Articles focusing on levels of catastrophizing and how catastrophizing affects pain levels and treatment outcomes for patients diagnosed with TMD were included, as well as studies reporting how treatment outcomes were affected by cognitive behavioral treatment as an addition to standard treatment for TMD. Reviews and case reports were excluded. Risk of bias was assessed with the Newcastle-Ottawa scale. Results: The literature search identified 266 articles. After screening of abstracts, the full texts of 59 articles were assessed. Of these, 37 articles, including 4,789 patients with TMD and 6,617 controls, met the inclusion criteria. Higher levels of pain catastrophizing were reported in patients with TMD, with a large effect size (Hedges' g = 0.86) compared to pain-free controls. Furthermore, associations of higher levels of catastrophizing with higher symptom severity and with poorer treatment outcome were reported together with indications of positive effects from cognitive behavioral therapy. Conclusion: The results suggest an association between catastrophizing and TMD that may affect not only symptom severity but also treatment outcome. Assessing levels of pain catastrophizing might therefore be valuable in the assessment and management of patients with TMD.
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| 7. |
- Jonsson Sjögren, Jakob, et al.
(författare)
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Characteristics and impact of pain from root-filled teeth : A practice-based cross-sectional study comparing painful teeth with and without signs of inflammatory dental disease
- 2024
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Ingår i: Journal of Oral and Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 38:1, s. 64-76
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Tidskriftsartikel (refereegranskat)abstract
- To compare pain characteristics, impact of pain and characteristics of patients with painful root-filled teeth with and without signs of inflammatory dental disease. This cross-sectional study was performed in the Public Dental Health services, Region orebro County, Sweden. Adult patients with >= 1 root-filled tooth identified at their regular check -up were included and assigned to one of two groups; those with >= 1 sign of inflammatory dental disease (DD+) and those without any such sign (DD-). Patients/teeth were compared regarding pain characteristics (intensity, frequency, duration, quality and provoking factors), impact of pain (medication intake, impact on life) and patient characteristics as background factors (general health, other bodily and orofacial pain). Statistics included descriptive data (frequency tables) and group comparisons (Chi-square, Fisher's Exact and Mann-Whitney U-tests). The DD+ group included 27 participants (30 teeth) and the DD- group 22 participants (23 teeth). On average, pain intensity was mild, the frequency most often recurrent, and the impact was low. Average pain duration since onset exceeded 2 years in both groups. The only observed between-group differences were average pain intensity; 3.1 (0-10 Numerical Rating Scale (NRS)) in DD- group compared to 1.6 for DD+ (p = 0.030), and tenderness to apical palpation; only reported in the DD+ group. The similarities in clinical presentation between the two groups underscore the difficulties in correctly distinguishing between pain of odontogenic and non-odontogenic origin in root-filled teeth with a standard clinical investigation. Additional diagnostic methods need to be investigated for their ability to differentiate between tooth pain or discomfort of different origins.
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| 8. |
- Kreiner, Marcelo, et al.
(författare)
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Orofacial Pain and Toothache as the Sole Symptom of an Acute Myocardial Infarction Entails a Major Risk of Misdiagnosis and Death
- 2020
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Ingår i: Journal of Oral & Facial Pain and Headache. - : QUINTESSENCE PUBLISHING. - 2333-0384 .- 2333-0376. ; 34:1, s. 53-60
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To provide an update of knowledge regarding the clinical presentation and neurophysiologic aspects of orofacial pain of cardiac origin in the form of a literature review. Methods: The peer-reviewed databases Scopus/Embase, NCBI (PubMed), and Science Direct were searched up to December 2018. Results: Patients with myocardial infarction presenting without chest pain run a higher risk of death due to missed diagnosis and subsequently a significantly greater delay between the onset of symptoms and arrival at the hospital. During myocardial ischemia, orofacial pain is reported by 4 in 10 patients and described as oppressive and/or burning. Up to 4% of myocardial infarction patients experience pain solely in the orofacial structures, women more often than men. Orofacial pain during myocardial ischemia is associated with ischemia within the inferior wall of the heart, suggesting the involvement of the vagal system. Conclusion: The clinician’s awareness of the full spectrum of clinical characteristics of a myocardial infarction constitutes a key factor in accurate diagnosis. Health care professionals and the general public should be aware of the possibility of myocardial infarction presenting with orofacial pain, toothache, or ear/temporomandibular joint pain as the only symptom.
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| 9. |
- Kroese, Johanna M, et al.
(författare)
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TMJ Pain and Crepitus Occur Early Whereas Dysfunction Develops Over Time in Rheumatoid Arthritis
- 2020
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0376 .- 2333-0384. ; 34:4, s. 398-405
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate inflammatory mediator levels in TMJ synovial fluid (SF) and blood and to investigate clinical TMJ symptoms in relation to general and TMJ symptom duration in patients with rheumatoid arthritis (RA).METHODS: Examination of 80 TMJs (68 patients; median age 55 years; 85% women) included the following variables: TMJ pain at rest, maximum mouth opening, and palpation; jaw movement capacity; number of painful movements; crepitus; and degree of anterior open bite. Levels of tumor necrosis factor (TNF), TNF soluble receptor II, interleukin 1β, IL-1 receptor antagonist, IL-1 soluble receptor II, and serotonin in TMJ SF and blood; systemic disease activity; and duration of general and TMJ symptoms were assessed. General symptom duration ≤ 2 years was considered early RA.RESULTS: TMJ symptoms predominantly developed within 5 years following general symptom onset. Logistic regression analysis showed that number of involved joints, general pain, maximum mouth opening, anterior open bite, and TNF plasma levels combined explained 46% of the distinction between early and established RA. Furthermore, TMJ pain at rest and maximum mouth opening, contralateral laterotrusion, painful movements, crepitus, and SF TNF levels combined explained 35% of the distinction. In these analyses, higher general pain and maximum mouth opening, TMJ pain on maximum mouth opening, and crepitus were associated with early RA.CONCLUSION: This study indicates that TMJ pain and crepitus in RA usually occur within 2 years following general symptom onset. Pain-related dysfunction and structural changes develop with time. TNF in plasma and TMJ SF are associated with this development. This makes early (clinical) recognition of pain and inflammation important, enabling early treatment to minimize later irreversible damage.
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| 10. |
- Lampa, Ewa, et al.
(författare)
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Relationship Between Psychosocial Factors and Pain in the Jaw and Neck Regions Shortly After Whiplash Trauma
- 2019
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing Co., Inc.. - 2333-0384 .- 2333-0376. ; 33:2, s. 213-219
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess jaw pain shortly after whiplash trauma in relation to neck pain, physical symptoms, depression, and jaw pain-related disability.Methods: A total of 181 cases (106 women and 75 men, mean ages 33.7 and 36.8 years, respectively) were examined within 1 month after a whiplash trauma and compared to 117 controls (68 women and 49 men, 34.2 and 30.9 years, respectively). Participants rated current jaw and neck pain intensity on a numeric rating scale and rated nonspecific physical symptoms and depression symptoms on subscales of the Symptom Checklist-90-Revised. The nonspecific physical symptoms were further analyzed with and without pain items. Disability related to jaw pain and neck pain was also assessed. Differences between groups were calculated using Mann-Whitney U test, and correlations were measured using Spearman correlation.Results: Compared to controls, cases reported higher current jaw and neck pain intensity (P < .0001), together with higher scores for physical nonpain and pain symptoms, depression, and jaw pain-related disability (P < .0001 for all). For cases, there were moderate correlations between nonspecific physical symptoms and jaw pain and neck pain, as well as between jaw pain-related disability and jaw pain and neck pain (r = 0.43 to 0.77, P < .0001 for all). Low correlations were observed between depression and jaw pain and neck pain (r = 0.34 to 0.39, both P < .0001).Conclusion: Shortly after a whiplash trauma, pain in the jaw and neck regions is associated with the severity of psychosocial factors. Thus, psychosocial factors may play a role in the development of pain in the jaw region after whiplash trauma.
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| 11. |
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| 12. |
- Leksell, Eva, et al.
(författare)
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Perceived Oral Health and Care of Children with Juvenile Idiopathic Arthritis : A Qualitative Study
- 2015
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 29:3, s. 223-230
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To increase knowledge about how children diagnosed with juvenile idiopathic arthritis (JIA) perceive their oral health and dental care. Methods: Fifteen interviews with children diagnosed with JIA, aged 6 to 16 years, were analyzed according to classical grounded theory. Results: The children's main concern about their oral health was identified as creating a positive identity after being diagnosed with JIA and learning to live with oral health problems. While attempting to cope with this concern, the children often endured in silence, the core category in the analysis. A variety of aspects were found of this core coping strategy, which were categorized as differentiating from the disease, working on personal caretaking and positive attitude, fighting fears and sadness, control of professional aid, and building supportive relationships. The results emphasize the importance for caregivers to show empathy and interest in the child as a person, to ask precise questions when taking case histories so the child does not remain silent, to provide psychosocial support and suggest positive coping strategies, to describe and administer treatments, and to give hope for the future. Conclusion: Awareness of the social interaction between a child diagnosed with JIA and health professionals as well as awareness of how to approach a child with longstanding illness are crucial for disclosing and treating the child's orofacial symptoms.
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| 13. |
- Lindfors, Erik, et al.
(författare)
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Effect of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain : A Randomized Controlled Study
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 34:4, s. 364-373
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To study the effect and cost-effectiveness of jaw exercise treatment in patients with masticatory myofascial pain. Methods: A total of 97 patients with myofascial pain according to the RDC/TMD were randomized into three groups: (/) jaw exercises; (2) stabilization appliance; or (3) no treatment. After 3 months, the patients were evaluated according to the following instruments: pain intensity according to a visual analog scale (VAS); global improvement according to the Patient Global Impression of Change scale (PGIC); depression and anxiety according to the Hospital Anxiety and Depression Scale (HADS); jaw function according to the Jaw Functional Limitation Scale (JFLS-20); consumption of analgesics; and frequency of tension-type headache. Results: Pain intensity during jaw movement decreased significantly more in the jaw exercise group compared to the no treatment group (P < .001). There was no statistically significant difference between the jaw exercise and stabilization appliance groups in this aspect. The patients in the treatment groups reported greater improvement on the PGIC compared to the no treatment group (P < .001). There was a significant decrease in headache frequency (P = .028), consumption of analgesics (P = .007), and JFLS scores (P = .008) in the jaw exercise group compared to the no treatment group. In the jaw exercise group, patients had fewer appointments and a lower mean treatment time compared to the group that received stabilization appliance treatment. Conclusion: Jaw exercises are effective in reducing pain intensity, headache, and consumption of analgesics in patients with masticatory myofascial pain. Jaw exercises are also cost-effective when compared to treatment with a stabilization appliance.
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| 14. |
- Lindfors, Erik, et al.
(författare)
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Jaw Exercises in the Treatment of Temporomandibular Disorders : An International Modified Delphi Study
- 2019
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence Publishing. - 2333-0376 .- 2333-0384. ; 33:4, s. 389-398
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises.Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from “strongly agree” to “strongly disagree.” The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts’ earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement.Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality.Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.
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| 15. |
- Lindfors, E., et al.
(författare)
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Patient Experiences of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain: A Qualitative Study
- 2017
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 31:1, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate patients' experiences of therapeutic jaw exercises fortreating masticatory myofascial pain. Methods: A total of 10 patients were selected for the interview study. All patients had received treatment with jaw exercises at a specialist clinic. Semi-structured interviews were conducted in a nonclinical environment according to an interview guide with 10 domains. The interviews were transcribed and translated into English. Systematic text condensation (STC) was used to arrange and analyze the text material. Results: In the systematic process of analyzing the qualitative data, four main themes were identified: "Patient Adherence," "Symptoms," "Treatment Effect," and "Participation." Most informants were initially skeptical of the jaw exercises due to their simplicity. Later on, the simplicity of the exercises and the fact that they did not need more advanced treatment were valued most by a majority of patients. Some informants suspected serious disease behind their symptoms. Treatment effects on pain and physical impairment were reported. To do the jaw exercises in conjunction with an already established routine seemed important to enhance adherence. Trust in the caregiver and being able to remedy their pain by themselves were also important to the informants. Conclusion: Jaw exercises are a useful treatment valued by patients due to their simplicity and effectiveness. However, before the treatment, patients should be informed about the cause of the symptoms, and any skepticism should be addressed. Results from this qualitative study cannot be generalized, but the study design and the selected population allow the results to be transferable to similar contexts.
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| 16. |
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| 17. |
- Nilsson, Ing-Marie, et al.
(författare)
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Treatment Seeking and Self-Constructed Explanations of Pain and Pain management Strategies Among Adolescents with Temporomandibular Disorder Pain
- 2016
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Ingår i: Journal of Oral & Facial Pain Headache. - Hanover Park, IL, United States : Quintessence. - 2333-0376 .- 2333-0384. ; 30:2, s. 127-133
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Forskningsöversikt (refereegranskat)abstract
- Aims: To explore adolescents' explanations of their temporomandibular disorder (TMD) pain, their pain management strategies for TMD pain, and their treatmentseeking behavior. Methods: One-on-one interviews were conducted with 21 adolescents aged 15 to 19 years old who had TMD pain and followed a semistructured interview guide. Subjects were strategically selected from patients referred to orofacial pain clinic. All participants had been examined and received a pain diagnosis based on the Research Diagnostic Criteria for TMD. The interviews focused on the adolescents' experiences of TMD pain, their strategies for handling pain, and how they seek care. The interviews were recorded, transcribed verbatim, and analyzed using qualitative manifest content analysis. Results: Qualitative manifest content analysis revealed two categories: (1) self-constructed explanations, with three subcategories (situation-based explanatory model, physical/bilogic model, and psychological explanatory model); and (2) pain management strategies, with four subcategories (social support, treatment, relaxation/rest, and psychological strategies). Adolescents used physical activities and psychological and pharmacologic treatment to manage pain. Reasons for seeking treatment were to be cured, to obtain explanation for their pain, and because their symtoms bother others. Conclusion: Adolescents living with TMD pain develop self-constructed explanations and pain management strategies. With access to these descriptions, dentists can be better prepared to have a dialouge with their adolescent patients about their own explanations of pain, the nature of pain, and in wich sitations the pain appears. Dentists can also explore adolescent patients' pain management stategies and perhaps also suggest new treatment stategies at an earlier stage.
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| 18. |
- Nordin, Sara, et al.
(författare)
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Achieved Competencies and Satisfaction in Temporomandibular Disorders and Orofacial Pain Education
- 2016
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0376 .- 2333-0384. ; 30:2, s. 156-164
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To assess dental students' achieved competencies and perceived satisfaction with their temporomandibular disorders (TMD) and orofacial pain education and to compare these with the results of their final examination in TMD and orofacial pain. METHODS: Dental students from two consecutive classes (2011/2012 and 2012/2013) at the Department of Orofacial Pain and Jaw Function at the dental school in Malmö, Sweden completed two self-evaluations, one at the beginning of semester seven and one at the end of semester eight. The questionnaire that they were given concerned achieved competencies and satisfaction with education in TMD and orofacial pain. Items focused on anatomy, physiology, and clinical training. Students estimated their competence and satisfaction on a numeric rating scale and described their idea of treating TMD and orofacial pain patients on a verbal rating scale. Outcome variables were tested with paired samples t test for differences over time and independent samples t test for between-class comparisons; both were adjusted for multiple testing with Bonferroni correction. RESULTS: Significant improvement in all items was observed for achieved competencies and satisfaction in both classes between semester seven and semester eight (P < .05). No differences in competencies or satisfaction occurred between classes at the end of the clinical course in semester eight (P > .05). CONCLUSION: This study has shown that expansion in undergraduate TMD and orofacial pain education at the dental school in Malmö has allowed all students to develop the same level of competence, independent of prior experience. The study also pointed out that continuous evaluation and enhancement of TMD and orofacial pain education in undergraduate dental education is beneficial
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| 19. |
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| 20. |
- Pigg, Maria, et al.
(författare)
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A comparative analysis of magnetic resonance imaging and radiographic examinations of patients with atypical odontalgia
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:3, s. 233-242
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To examine (1) the occurrence of magnetic resonance imaging (MRI) signal changes in the painful regions of patients with atypical odontalgia (AO) and (2) the correlation of such findings to periapical bone defects detected with a comprehensive radiographic examination including cone beam computed tomography (CBCT). METHODS: A total of 20 patients (mean age 52 years, range 34 to 65) diagnosed with AO participated. Mean pain intensity (± standard deviation) was 5.6 ± 1.8 on a 0-10 numerical rating scale, and mean pain duration was 4.3 ± 5.2 years. The inclusion criterion was chronic pain (> 6 months) located in a region with no clear pathologic cause identified clinically or in periapical radiographs. In addition to a clinical examination and a self-report questionnaire, the assessments included radiographic examinations (panoramic, periapical, and CBCT images), and an MRI examination. Changes in MRI signal in the painful region were recorded. Spearman's rank correlation between radiographic and MRI findings was calculated. RESULTS: Eight of the patients (40%) had MRI signal changes in the pain region. The correlation to radiographic periapical radiolucencies was 0.526 (P = .003). Of the eight teeth displaying changes in MRI signal, six showed periapical radiolucency in the radiographs. CONCLUSION: MRI examination revealed no changes in the painful region in a majority of patients with AO, suggesting that inflammation was not present. MRI findings were significantly correlated to radiographic findings
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| 21. |
- Pillai, Rajath Sasidharan, et al.
(författare)
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Assessment of Somatosensory Function, Pain, and Unpleasantness in Two Surrogate Models of Trigeminal Nerve Damage : A Randomized, Double-Blind, Controlled Crossover Study.
- 2020
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Ingår i: Journal of Oral and Facial Pain & Headache. - : Quintessence. - 2333-0376 .- 2333-0384. ; 34:1, s. 92-107
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Tidskriftsartikel (refereegranskat)abstract
- To assess the pain and/or unpleasantness and the somatosensory changes caused by two experimental models of trigeminal nerve damage (topical application of capsaicin and local anesthetics) in healthy participants using extensive evaluation tools. Methods: This double-blinded, randomized, placebo-controlled, crossover study included 20 healthy adult participants who underwent three separate sessions of testing. In each session, the psychophysical quantitative sensory testing (QST) and the electrophysiologic electrically evoked trigeminal nociceptive-specific blink reflex (nBR) investigations were performed at baseline. Following a 15-minute topical application of 0.1% capsaicin, 5% EMLA, or Vaseline (placebo) agents, the maximum numeric rating scale pain and unpleasantness scores were recorded. Additionally, qualitative sensory testing and somatosensory mapping were performed. The QST and nBR investigations were repeated immediately after each application. Data were analyzed using repeated-measures analysis of variance. Results: Capsaicin application was associated with significantly higher pain and unpleasantness scores when compared to EMLA and Vaseline (P < .001), with varied bidirectional somatosensory changes among the participants and significant loss of thermosensory function (P < .030). EMLA application induced loss of thermal and mechanical somatosensory function (P < .030) and a significant reduction in electrically evoked pain scores on nBR investigation (P < .001). No significant changes were seen in the electrophysiologic component of the nBR after any of the applications (P = .922). Conclusion: Topical capsaicin and EMLA application mimicked certain aspects of somatosensory changes seen in trigeminal nerve damage patients and may be used as surrogate models of such changes.
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| 22. |
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| 23. |
- Schiffman, E, et al.
(författare)
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Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications : recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 28:1, s. 6-27
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS: Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS: The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self report instrument sets. The screening instruments' 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION: The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations
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| 24. |
- Sharma, Sonia, et al.
(författare)
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Prevalence of facial pain and headache in Sweden
- 2021
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence Publishing. - 2333-0384 .- 2333-0376. ; 35:2, s. 139-149
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To compare the prevalence of facial pain and headache across various regions in Sweden.METHODS: This study involved a comparison of cross-sectional questionnaire studies over a period of 10 years including 128,193 individuals and assessed facial pain, pain on function, and headache. Participants included (1) all Public Dental Service patients aged 16 to 90 years in Västerbotten (n = 57,283) and Gävleborg (n = 60,900); and (2) random samples of residents in Kalmar (n = 3,560) and Skåne (n = 6,450). Facial pain and pain on function were assessed for all participants, and headache was also assessed for participants in Kalmar and Skåne. Descriptive statistics were used to estimate unadjusted prevalence estimates and demographic characteristics. Prevalence estimates were adjusted for age and sex using weighted distributions from the 2015 data in the Swedish population registry before comparisons across the regions.RESULTS: Overall, the prevalence of facial pain and headache were significantly higher in female than in male participants (P < .01). The standardized prevalence of facial pain was 4.9% in Västerbotten, 1.4% in Gävleborg, 4.6% in Kalmar, and 7.6% in Skåne. For headache, the standardized prevalence was 18.9% in Kalmar and 21.3% in Skåne. In Skåne, individuals with facial pain had a 15-fold higher odds of headache than those without.CONCLUSION: In the present Swedish epidemiologic study, the prevalence of facial pain ranged from 1.4% in Gävleborg to 7.6% in Skåne. Besides different sampling frames and other population characteristics, the presence of a high number of immigrants in Skåne may account for some differences in pain prevalence across the Swedish regions.
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| 25. |
- Slade, Gary D., et al.
(författare)
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Overlap of Five Chronic Pain Conditions : Temporomandibular Disorders, Headache, Back Pain, Irritable Bowel Syndrome, and Fibromyalgia
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 34:Suppl, s. 15-28
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess cohort retention in the OPPERA project and to compare the degree of overlap between pairs of chronic overlapping pain conditions (COPCs) using a cross-sectional analysis of data from 655 adults who completed followup in the OPPERA study. Methods: Subjects were classified for the absence or presence of each of the five COPCs. The extent of overlap beyond chance was quantified using odds ratios, which were calculated using binary logistic regression models. Results: While overlap was the norm, its magnitude varied according to COPC: 51% of people with headache had one or more overlapping COPCs, and this proportion increased to 90% for people with fibromyalgia. The degree of overlap between pairs of COPCs also varied considerably, with odds ratios being greatest for associations between musculoskeletal conditions (fibromyalgia,temporomandibular disorders, and low back pain) and less pronounced for overlap invoMng headache or IBS. Furthermore, univariate associations between some pairs of COPCs were nullified after adjusting for other COPCs. Conclusion: There was greater overlap between fibromyalgia and either temporomandibular disorders or low back pain than between other pairs of COPCs. While musculoskeletal conditions exhibited some features that could be explained by a single functional syndrome, headache and irritable bowel syndrome did not.
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| 26. |
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| 27. |
- Zhang, Yuanxiu, et al.
(författare)
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Comparison of Pain-Generated Functional Outcomes in Experimental Models of Delayed-Onset Muscle Soreness and Nerve Growth Factor Injection of the Masticatory Muscles
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 34:4, s. 311-322
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare two pain models of myalgic TMD, delayed-onset muscle soreness (DOMS) and injections of nerve growth factor (NGF), in terms of pain-related and motor function outcomes, as well as activity-related temporal summation. Methods: Fifty age- and gender-matched healthy participants were recruited and randomized into one of three groups: to a repeated eccentric contraction task to cause DOMS (n = 20), to receive NGF injections into the masseter muscle (n = 20), or to a control group (n = 10). Mechanical sensitivity of masticatory muscles, chewing parameters, jaw function limitation, maximum bite force, and activity-related temporal summation were assessed at baseline and at days 1, 2, and 7 following the intervention. Results: Compared to baseline, both model groups showed increased mechanical sensitivity, jaw function limitation, pain on chewing, and decreased chewing efficiency, lasting longer in the NGF group than in the DOMS group (P < .05). Furthermore, also compared to baseline, the NGF group showed increased pain on maximum bite and decreased pain-free maximum opening (P < .05). No increases in activity-related temporal summation were shown for any of the model groups when compared to baseline or the control group (P > .05). Conclusion: Both models produced similar pain-related outcomes, with the NGF model having a longer effect. Furthermore, the NGF model showed a more substantial effect on motor function, which was not seen for the DOMS model. Finally, neither of the models were able to provoke activity-related temporal summation of pain.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Dawson, Andreas, et al.
(författare)
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Effects of Acute Experimental Stress on Pain Sensitivity and Cortisol Levels in Healthy Participants : A Randomized Crossover Pilot Study
- 2020
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence publishing co inc. - 2333-0384. ; 34:3, s. 281-290
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate pain sensitivity in the masseter muscle and index finger in response to acute psychologic stress in healthy participants. Methods: Fifteen healthy women (23.7 +/- 2.3 years) participated in two randomized sessions: in the experimental stress session, the Paced Auditory Serial Addition Task (PASAT) was used to induce acute stress, and in the control session, a control task was performed. Salivary cortisol, perceived stress levels, electrical and pressure pain thresholds (PTs), and pain tolerance levels (PTLs) were measured at baseline and after each task. Mixed-model analysis was used to test for significant interaction effects between time and session. Results: An interaction effect between time and session occurred for perceived stress levels (P < .001); perceived stress was significantly higher after the experimental task than after the control task (P < .01). No interaction effects occurred for salivary cortisol levels, electrical PTs, or pressure PTLs. Although significant interactions did occur for electrical PTL (P < .05) and pressure PT (P < .001), the simple effects test could not identify significant differences between sessions at any time point. Conclusion: The PASAT evoked significant levels of perceived stress; however, pain sensitivity to mechanical or electrical stimuli was not significantly altered in response to the stress task, and the salivary cortisol levels were not altered in response to the PASAT. These results must be interpreted with caution, and more studies with larger study samples are needed to increase the clinical relevant understanding of the pain mechanisms and psychologic stress.
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| 34. |
- Dawson, Andreas, et al.
(författare)
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Pain and intramuscular release of algesic substances in the masseter muscle after experimental tooth-clenching exercises in healthy subjects
- 2013
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Ingår i: Journal of Orofacial Pain. - : Quintessence Publishing. - 1064-6655 .- 1945-3396 .- 2333-0384. ; 27:4, s. 350-360
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:To investigate whether experimental tooth clenching leads to a release of algesic substances in the masseter muscle.METHODS:Thirty healthy subjects (16 females, 14 males) participated. During two sessions, separated by at least 1 week, intramuscular microdialysis was performed to collect masseter muscle 5-hydroxytryptamine (5-HT) and glutamate as well as the metabolic markers pyruvate and lactate. Two hours after the start of microdialysis, participants were randomized to a 20-min repetitive experimental tooth-clenching task (50% of maximal voluntary contraction) or a control session (no clenching). Pain and fatigue were measured throughout. The Friedman and Wilcoxon tests were used for statistical analyses.RESULTS:No alterations were observed in the concentrations of 5-HT, glutamate, pyruvate, and lactate over time in the clenching or control session, or between sessions at various time points. Pain (P < .01) and fatigue (P < .01) increased significantly over time in the clenching session and were significantly higher after clenching than in the control session (P < .01).CONCLUSION:Low levels of pain and fatigue developed with this experimental tooth-clenching model, but they were not associated with an altered release of 5-HT, glutamate, lactate, or pyruvate. More research is required to elucidate the peripheral release of algesic substances in response to tooth clenching.
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| 35. |
- Gillborg, Susanna, et al.
(författare)
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Temporomandibular Disorder Pain and Related Factors in an Adult Population : A Cross-Sectional Study in Southern Sweden
- 2017
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384. ; 31:1, s. 37-45
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To measure the prevalence of temporomandibular disorder (TMD) pain and examine its association with gender and other factors in an adult population in southern Sweden. Methods: In 2006, a questionnaire was sent to randomly selected individuals (n = 10,000) aged 20 to 89 years. Two specific questions were used to screen individuals with TMD pain, and an additional 16 questions were analyzed regarding the subjects' relation to TMD pain. The chi-squared test was used to compare the distribution of categorical variables, and factors possibly related to TMD pain were analyzed by using logistic regression models with a likelihood-ratio test. Results: The response rate was 63%. The prevalence of TMD pain (once a week or more) was 11.0% (95% confidence interval [CI]: 10.2% to 11.8%). Women reported experiencing TMD pain more frequently than men. Further, the prevalence of TMD pain increased significantly in adults < 50 years of age. Those with TMD pain reported headaches much more frequently than those without TMD pain, and individuals with TMD pain self-reported poorer general health than those without it. Individuals with TMD pain also had higher scores on the oral health impact profile (OHIP-14). Moreover, the TMD pain group was three times more likely to have had a dentist or hygienist comment on their tooth wear than the non TMD pain group. Conclusion: The prevalence of TMD pain in the adult population in southern Sweden was 11%. Factors related to TMD pain were female gender, age < 50 years, headaches, self-reported poor general health, high scores on the OHIP-14, and tooth wear. Age was the only factor that showed a significant difference between genders for TMD pain.
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| 36. |
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| 37. |
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| 38. |
- Kreiner, Marcelo, et al.
(författare)
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Craniofacial pain of cardiac origin is associated with inferior wall ischemia
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence Publishing. - 2333-0384. ; 28:4, s. 317-321
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate possible associations between the presence of craniofacial pain of cardiac origin and the location of cardiac ischemia and conventional risk factors. Methods: A total of 326 consecutive patients with confirmed myocardial ischemia (192 males, 134 females, mean age 64 years) were studied. Demographic details, health history, risk factors, prodromal symptoms, electrocardiogram (ECG) findings, and pain characteristics during the ischemic episode were assessed. The location of the ischemia according to the ECG findings was categorized as anterior, inferior, or lateral. Univariate chi-square analyses and a multivariate logistic regression model were used for data analysis. Two age subgroups (< 65 and > 65) were established when controlling for covariates. Results: Craniofacial pain of cardiac origin was significantly associated with an inferior localization of cardiac ischemia (P < .001) and was more frequently reported in diabetic patients (P = .014). Thirty-eight patients (12%) did not experience chest pain during the myocardial ischemia. Nine patients (3%) experienced a prodromal angina episode without chest pain. Conclusion: The occurrence of craniofacial pain during myocardial ischemia, with or without an acute myocardial infarction, was associated with ischemia within the inferior wall. This result suggests the involvement of the vagal afferent system in the mechanisms of craniofacial pain of cardiac origin.
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| 39. |
- Lanefelt, Sarah Vaderlind, et al.
(författare)
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Tooth Clenching Until Exhaustion Evokes Exercise-Induced Hypoalgesia in Healthy Persons and in Patients with Temporomandibular Disorders.
- 2019
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence Publishing. - 2333-0384. ; 33:1
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate whether static jaw clenching can activate endogenous pain modulation and to compare the magnitude between healthy individuals and patients with temporomandibular disorder (TMD) myalgia.METHODS: Thirty-three healthy volunteers (17 women and 16 men) and 20 women with TMD myalgia participated. Exercise-induced hypoalgesia (EIH) was examined by recording pressure pain thresholds (PPTs) in the masseter (MA) and brachioradialis (BR) muscles during tooth clenching until exhaustion. Pain and fatigue were assessed before and after clenching, and pain amplification was examined by applying a painful mechanical pressure at the MA for 2 minutes while assessing pain every 30 seconds. Analyses of data included repeated measures analysis of variance.RESULTS: In the contracting MA, PPTs increased over time in all three groups (P < .001), while PPTs in the relaxed BR increased only in the men (P = .045). Pain intensity and fatigue in the MA increased after contraction in all groups (P < .003) and was higher in the women with TMD than in the healthy women (P < .001). Only the women with TMD showed pain amplification (P < .001).CONCLUSION: Tooth clenching until exhaustion could activate EIH locally; ie, the magnitude of EIH in the MA was similar in women with TMD myalgia and pain-free women, indicating no deficient EIH in women with TMD. However, only women with TMD showed pain amplification during application of continuous painful pressure.
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| 40. |
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| 41. |
- Lu, Shengyi, et al.
(författare)
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Effect of Experimental Periodontal Ligament Pain on Gingival Somatosensory Sensitivity
- 2017
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Ingår i: JOURNAL OF ORAL & FACIAL PAIN AND HEADACHE. - : Quintessence. - 2333-0384. ; 31:1, s. 72-79
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To use a randomized, blinded, crossover design to evaluate the possible heterotopic effects of experimental periodontal ligament pain on adjacent gingival somatosensory sensitivity. Methods: A total of 12 healthy volunteers (8 female, 4 male; mean age standard error in means (SEM): 28 1 years) participated in two randomized experimental quantitative sensory testing (QST) sessions, one in which capsaicin (experimental) was injected into the periodontal ligament and one in which isotonic saline (control) was injected. A total of 13 standardized QST measures were obtained on the buccal attached gingiva of a maxillary central incisor before, immediately after, and 30 minutes after injection of 30 mu L of 5% capsaicin or isotonic saline into the periodontal ligament of the same incisor. The injection-evoked pain was evaluated on a 0-10 numeric rating scale (NRS). QST data were analyzed with two-way repeated measurement analysis of variance. Results: Capsaicin injected into the periodontal ligament evoked moderate levels of pain (mean peak NRS SEM: capsaicin: 5.5.7; control: 0.6 0.5 [P < .001]). Capsaicin injected into the periodontal ligament significantly modulated gingival somatosensory sensitivity: increased sensitivity to warmth and painful heat stimuli occurred immediately and 30 minutes after the injection (P < .025), whereas decreased sensitivity to both tactile and painful mechanical stimuli (P < .011) occurred immediately after the injection and to painful mechanical stimuli only after 30 minutes (P = .016). No somatosensory changes were detected following the injection of isotonic saline (P > .050). Conclusion: Capsaicin injected into the periodontal ligament caused gain of heterotopic somatosensory sensitivity toward warmth and painful heat stimuli as well as reduction in mechanical sensitivity of the gingiva adjacent to the injected tooth. These findings may have implications for interpretation of somatosensory functions in patients with chronic intraoral pain, where gingival somatosensory profiles similar to those detected after capsaicin injection in the present study may be interpreted as signs of nerve damage.
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| 42. |
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| 43. |
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| 44. |
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| 45. |
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| 46. |
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| 47. |
- Ohrbach, Richard, et al.
(författare)
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Clinical Characteristics of Pain Among Five Chronic Overlapping Pain Conditions
- 2020
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384. ; 34:Suppl, s. 29-42
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the pain characteristics of five index chronic overlapping pain conditions (COPCs) and to assess each COPC separately in order to determine whether the presence of comorbid COPCs is associated with bodily pain distribution, pain intensity, pain interference, and high-impact pain of the index COPC. Methods: Data were from a convenience sample of 655 US adults, of whom 388 had one or more of the five COPCs: painful temporomandibular disorders, headache, low back pain, irritable bowel syndrome, and/or fibromyalgia. Data were collected using pain location checklists and self-report questions regarding pain attributes. The contributions of the COPCs to reported pain intensity and interference were assessed using multivariable regression models. Results/Conclusion: Heat maps from a pain body manikin illustrated that very little of the body was pain free within these COPCs. All pain attributes were the most severe for fibromyalgia and the least severe for irritable bowel syndrome. Within each index COPC, pain intensity, pain interference, and the proportion of participants with high-impact pain increased with each additional comorbid COPC up to four or more COPCs (including the index COPC) (P < .01). High-impact pain associated with an index COPC was influenced by type and number of comorbid COPCs, largely in a gradient-specific manner.
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| 48. |
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| 49. |
- Sharma, Sonia, et al.
(författare)
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Attributes Germane to Temporomandibular Disorders and Their Associations with Five Chronic Overlapping Pain Conditions
- 2020
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384. ; 34:Suppl, s. 57-72
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate whether TMD-related characteristics are indeed specific to TMD or whether they are also associated with other chronic overlapping pain conditions (COPCs). Methods: In this cross-sectional study, 22 characteristics related broadly to TMD (eg, jaw kinesiophobia, overuse behaviors, and functional limitation) were measured in 178 painful TMD cases who were also classified according to four COPCs: headache, low back pain, irritable bowel syndrome, and fibromyalgia. Differences in mean subscale scores were compared according to individual chronic pain conditions and according to number of COPCs. Results: Headache, low back pain, irritable bowel syndrome, and fibromyalgia were each associated (P < .05) with higher values of at least one TMD-relevant characteristic. In the multivariable analysis, TMD was independently associated with 20 of the 22 characteristics (P < .01), and other COPCs were associated variably. A critical threshold existed between the number of COPCs and TMD characteristics: all characteristics were elevated for subjects with >= 3 COPCs (P <=.01). Conclusion: The overlap between COPCs and characteristics typically regarded as specific to painful TMD has implications for treatment targeted at both the local TMD condition and the broader pain disorder underlying the COPC(s). In TMD patients, the overall burden of pain from COPCs may create a shift in the pain-processing systems that underlie these TMD-relevant characteristics.
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| 50. |
- Storm Mienna, Christina, et al.
(författare)
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"Grin(d) and bear it" : narratives from Sami women with and without temporomandibular disorders. A qualitative study.
- 2014
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence publishing. - 2333-0384. ; 28:3, s. 243-251
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To explore thoughts, experiences, and beliefs regarding temporomandibular disorders (TMD) among Sami women with and without TMD in order to gain insights into their health care experiences and to generate a hypothesis regarding factors associated with long-standing TMD.METHODS: Qualitative thematic interviews were conducted with a strategic sample of 17 Sami women, of whom 10 had a TMD diagnosis according to the Research Diagnostic Criteria for TMD and 7 age-matched women who had no signs or symptoms of TMD. Their ages were between 23 and 58 years. The thematic interviews were audiotaped, transcribed verbatim, and analyzed based on Grounded Theory, a qualitative methodology aiming to generate hypotheses grounded in the gathered data.RESULTS: The core category that evolved was "Grin(d) and bear it," which summarizes the Sami participants' various ways and stages of processing and handling the interacting categories (triggers, strains, distrust, and reconciliation with pain and/or difficulties in life). They described divergent as well as similar understandings of triggering factors. Maintaining factors were described as mental-physical strain and stress, and also a jaw-clenching behavior. Women without TMD contributed with factors that helped them to handle strains, reconcile, and stay healthy. They relied on strong social support.CONCLUSION: Based on the analysis, the following hypothesis was generated: Women with TMD, associated headaches, and neck-shoulder pain may benefit from efforts aimed at empowering them to use their own abilities to reduce stress behavior, strain, and disuse of the jaw. Rehabilitation strategies in groups might increase their sense of coherence and increase social support, which seems to be more limited than in women with no symptoms of TMD.
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