Aims Symptoms of central sensitization syndrome (CSS) were evaluated among three different groups of temporomandibular disorder (TMD) patients. Additionally, TMD group differences in pain and pain-related disability were assessed, as well as emotional distress. Methods Participants were 250 patients with symptoms of acute TMD, recruited from dental clinics within a major metropolitan area. Sequential regressions and multivariate analyses of covariance were conducted in order to make group comparisons. Results Those with a TMD Muscle Disorder [i.e., myofacial TMD (m-TMD)] and those with more than one TMD diagnosis, had the most symptoms of CSS and higher reports of pain and pain-related disability. Moreover, emotional distress accounted for a substantial amount of the variance for physical symptoms and mediated all TMD comparisons. Conclusions Myofacial TMD is characterized by a high degree of comorbidity of symptoms of CSS and associated emotional distress.

Aims To assess whether a biobehavioral intervention would be more effective for patients with myogenous temporomandibular disorder (m-TMD) when compared to other patients receiving either a self-care intervention or no intervention. Three outcomes were assessed: psychosocial distress; pain; and functioning. Methods Participants (n=435) were from community dental clinics in the Dallas-Fort Worth Metroplex seeking treatment for their acute TMD symptoms, and were recruited between 2008 and 2013. Outcome evaluations were conducted immediately post-intervention, as well as at 1- and 2-years after the interventions. For the current study, analyses using two-level hierarchical Multilevel Linear Models (MLMs) were conducted. Results Contrary to expectations, patients did not respond differently to the intervention based on their TMD diagnosis. However, acute m-TMD patients, especially those who had other comorbid TMD diagnoses, reported the highest levels of pain and pain-related symptoms and disability. They also exhibited poorer jaw functioning, especially if they were at high-risk for chronic TMD. Conclusion This study supports the finding that acute m-TMD tends to result in more severe symptom presentations, particularly if diagnosed in combination with other TMD diagnoses. Additionally, patients do not appear to respond better to biobehavioral treatment or self-care on the basis of their diagnoses.

The current preliminary study investigated the relative effectiveness of an early intervention program on self‐reported pain, pain‐related disability, emotional distress, and symptoms of temporomandibular joint and muscle disorder (TMJMD) as defined by the Research Diagnostic Criteria for TMD (RDC/TMD). These included symptoms of Axis I Group I muscle disorders, Group II disc displacements, and Group III bone deficiencies. Participants were 271 patients recruited from community dental clinics within a large major metropolitan area. Participants at a high risk for chronicity were randomly assigned to a high‐risk self‐care intervention or a high‐risk biobehavioral intervention and were evaluated for their responsiveness immediately following treatment. As predicted, several symptoms of TMD were significantly reduced immediately following the intervention. Though these results are preliminary, it is implicated that the intervention may lead to symptom improvement.

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