| 1. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Increasing gender differences in the prevalence and chronification of orofacial pain in the population
- 2020
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Ingår i: Pain. - : Lippincott Williams & Wilkins. - 0304-3959 .- 1872-6623. ; 161:8, s. 1768-1775
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Tidskriftsartikel (refereegranskat)abstract
- Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course is lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, two screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010-2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least two consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (OR 2.58, 95% CI 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (IRR 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (IRR 2.56, 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.
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| 2. |
- Ilgunas, Aurelija, et al.
(författare)
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Conceptualizing the clinical decision-making process in managing temporomandibular disorders : a qualitative study
- 2021
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Ingår i: European Journal of Oral Sciences. - : John Wiley & Sons. - 0909-8836 .- 1600-0722. ; 129:5
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Tidskriftsartikel (refereegranskat)abstract
- Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision-making process forTMD. The challenges were primarily related to organisational factors and lack of self-confidence. This identifies a need for re-organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self-confidence. The complexity of the decision-making process for TMD makes the study findings applicable in other dental situations.
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| 3. |
- Larsson, Johan, et al.
(författare)
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The feasibility of gym-based exercise therapy for patients with persistent neck pain
- 2020
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 20:2, s. 261-272
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Persistent neck pain is common and can be detrimental to the health of those who are affected. This is particularly common after neck trauma, where it poses a challenge to health care providers. In this paper, we present the design and results of a study aimed primarily at assessing the feasibility of a supervised exercise intervention for patients with persistent neck pain after trauma. As a secondary aim, we analyzed the results of the intervention.Methods: We designed and conducted a feasibility study using a mixed methods design. Ten patients with persistent neck pain (nine with a history of neck trauma and one with sudden onset of neck pain) were recruited from a specialized pain rehabilitation center and underwent a gym-based individual exercise therapy intervention, supervised by a physical therapist. We assessed the feasibility of the exercise therapy intervention based on the experiences of the patients and physical therapists. We analyzed both quantitative and qualitative results using descriptive statistics, content analysis, and questionnaires.Results: The study found the exercise therapy to be a feasible alternative for patients with persistent neck pain. Most of the practical aspects of the intervention and study were executed as planned, and the study was well received by the patients, who found it a valuable part of their rehabilitation. In the quantitative analysis, improvements were observed on the Neck Disability Index, numerical rating scale for pain, EuroQol 5D, and physical activity, with scores on the Neck Disability Index showing a statistically significant improvement. Scores on the Disability Rating Index showed a non-significant deterioration. The qualitative analysis uncovered one overarching theme and four themes for the patients and three themes for the physical therapist.Conclusions: The exercise therapy intervention seems to be feasible with favorable outcomes for the patients. The quantitative and qualitative analyses demonstrated exercise therapy to be beneficial from several different perspectives. However, although structured, the training needs customization and individual adaption from a clinical reasoning perspective in order to meet each patient’s individual needs.Implications: This study shows that supervised gym-based exercise therapy is feasible for patients with severe, persistent neck pain. It facilitates and motivates the execution of a larger, controlled trial, which might then lead to a new and potentially effective addition to the toolbox of all health care providers treating patients with persistent neck pain.
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| 4. |
- Lövgren, Anna, et al.
(författare)
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A high prevalence of TMD is related to somatic awareness and pain intensity among healthy dental students
- 2018
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 76:6, s. 387-393
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Dental students have been identified as a group with high risks of developing both temporomandibular disorders (TMD) and psychosocial conditions. Our primary aim was to evaluate the cross-sectional prevalence of TMD diagnoses, as defined in the Diagnostic Criteria (DC)/TMD, among dental students. The secondary aim was to evaluate the prevalence and association of behavioural and psychosocial factors in relation to DC/TMD diagnoses.Materials and methods: The study was conducted among undergraduate dental students during the second semester of their third year at the Department of Odontology, Medical Faculty, Umeå University, Sweden. Three consecutive cohorts were recruited during August in 2013, 2014, 2015. In total, 54 students were included and examined according the DC/TMD procedure.Results and conclusions: The prevalence of any DC/TMD diagnosis was 30%. The most prevalent TMD diagnosis was myalgia. Individuals with a TMD-pain diagnosis (i.e. myalgia or arthralgia) reported significantly higher pain intensity levels according to the Graded Chronic Pain Scale (GCPS) as compared to individuals without TMD-pain (Fisher’s exact test p < .001, two-sided). In addition, individuals with any TMD scored significantly higher jaw functional limitations according to the Jaw Functional Limitation Scale 20 (JFLS-20, p < .001) and oral parafunctions according to the Oral Behavior Checklist (OBC, p = .005) as compared to individuals without TMD. The psychosocial factors evaluated did not differ between individual with or without a TMD diagnosis. The majority of the dental students reported symptoms that are already identified as risk factors for developing TMD and pain conditions. However, longitudinal data are needed to evaluate how this evolves over time.
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| 5. |
- Storm Mienna, Christina, et al.
(författare)
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Patients' experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain
- 2019
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Ingår i: Acta Odontologica Scandinavica. - Abingdon : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 77:7, s. 495-501
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate temporomandibular disorder (TMD) patients’ experiences of a supervised jaw-neck exercise programme.Materials and methods: The study used a mixed method design. All patients were diagnosed with myalgia according to the Research Diagnostic Criteria for TMD and divided into local myalgia (n = 50; 38 women, mean age 43 yrs, SD 14), and myalgia with generalized pain (n = 28; 27 women, mean age 43 yrs, SD 13). Patients participated in a ten-session supervised exercise programme that included relaxation, coordination and resistance training of the jaw, neck and shoulders. After the 10 sessions an evaluation form was filled out including both open- and closed-ended questions. The quantitative analysis was based on closed-ended questions concerned experience, adaptation and side-effects from the exercise programme. The qualitative analysis was employing inductive content analysis of open-ended questions.Results: Patients reported similar positive overall experiences of exercise regardless of diagnosis, although more individuals in the general pain group experienced pain during training (57%) compared to the local pain group (26%; p = .015). Patients in both groups shared similar experiences and acknowledged the possibility to participate in an individualized and demanding exercise programme. They expressed feelings of being noticed, taken seriously and respectful care management to be key factors for successful treatment outcome. The exercise programme was acknowledged as a valuable part of treatment.Conclusion: The hypothesis generated was that individualized and gradually demanding exercise in the rehabilitation process of TMD stimulates self-efficacy and confidence in chronic TMD patients regardless of whether the pain was localized or combined with wide-spread pain.
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