Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated

Abstract

Objective: The aim of this study was to investigate the association among painful temporomandibular disorders (TMD), self reported tinnitus, and levels of depression. Method: The sample consisted of 224 individuals with ages ranges from 18 to 76 years. The Research Diagnostic Criteria for Temporomandibular Disorders Axis I were used to classify TMD and Axis II were used for self reported tinnitus, and to score the levels of depression. The odds ratio (OR) with 95% confidence interval (CI) was applied. Results: The presence of painful TMD without tinnitus was significantly associated with moderate/severe levels of depression (OR=9.3, 95%; CI: 3.44-25.11). The concomitant presence of painful TMD and tinnitus self-report increased the magnitude of the association with moderate/severe levels of depression (OR=16.3, 95%; CI, 6.58-40.51). Conclusion: Painful temporomandibular disorders, high levels of depression, and self reported tinnitus are deeply associated. However, this association does not imply a causal relationship.Keywords: depression, facial pain, tinnitus. REsumoObjetivo: Investigar a associação entre disfunção temporomandibular (DTM) dolorosa, auto-relato de zumbido e níveis de depressão. Método: A amostra foi composta por 224 indivíduos com idades de 18 a 76 anos. O Research Diagnostic Criteria for Temporomandibular Disorders, eixo I, foi usado para classificar a DTM e o eixo II para obtenção do auto-relato de zumbido e dos níveis de depressão. Para a análise dos dados, foi aplicado o teste odds ratio (OR) com intervalo de confiança (IC) de 95%. Resultado: Somente a presença de DTM dolorosa estava significativamente associada aos níveis de depressão moderado/severo (OR=9,3, 95%; IC: 3,44-25,11). A presença concomitante de DTM dolorosa e auto-relato de zumbido aumentaram a magnitude da associação com os níveis de depressão moderado/severo (OR=16,3; 95% IC: 6,58-40,51). Conclusão: Disfunção temporomandibular dolorosa, altos níveis de depressão e auto-relato de zumbido estão fortemente associados. Entretanto, o desenho do estudo não permite estabelecer uma relação causal entre essas três entidades.Palavras-chave: depressão, dor facial, zumbido.Tinnitus is defined as a phantom sensation because sound is perceived in the absence of a physical sound source 1 . It is clinically heterogeneous, reflecting multiple etiologies, and its complexity is related to its biological and psychological components 2 . Studies have observed tinnitus complaints more often in patients with temporomandibular disorders (TMD) than in those without TMD [3][4] , and tinnitus patients had more TMD signs and symptoms 5. Furthermore, signs of TMD may be a risk factor for the development of tinnitus Temporomandibular disorders refer to a group of conditions characterized by signs and symptoms, including pain in the temporomandibular joint (TMJ), and/or masticatory muscles, and/or TMJ sounds, and deviations or restriction in mandibular range of motion 7 . The first hypothesis for the association between tinnitus and TMD was descri...

Evaluation of depressive symptoms and quality of life in individuals with tinnitus and temporomandibular disorders

“…It can be divided into objective and subjective, the first being audible for someone other than the patient (PINTO et al, 2014). Various studies have separately explored the association between high levels of depression and tinnitus (LANGGUTH et al, 2011), and elevated depression and TMD levels (DOHRENWEND et al, 1999;FERNANDES et al, 2013). However, there is a lack of research investigating such variables jointly, tests applied are presented in Figure 1.…”

“…However, there is a lack of research investigating such variables jointly, tests applied are presented in Figure 1. given that tinnitus, depression, and TMD are highly prevalent (FERNANDES et al, 2014) and have great impact on the lives of individuals (FERNANDES et al, 2013). In a study conducted in 2013 by Fernandes et al, of the individuals who had painful TMD (myalgia, arthralgia, or osteoarthritis of the TMJ) and tinnitus, 85% had moderate or severe depression levels.…”

“…Depression can be directly influenced by the presence of chronic pain (present for at least 6 months) (FERNANDES et al, 2013), amplifying psychological changes, and altering the severity, the perception, and the intensity of TMD (HILGENBERG et al, 2012). In the presence of trigger points, characteristic of myofascial pain, depression, as well as poor posture, psychological stress, and lack of sleep, can perpetuate the existence of such points, and consequently of pain ( JAEGER, 2012).…”

“…The disorders occur in over 10% of all individuals, restricting their ability to perform everyday functions at home and at work (FERENDIUK; ZAJDEL; PIHUT, 2002). TMD patients often report the presence of tinnitus as an associated symptom, and the comorbidity relationship between these changes is poorly understood (CHERIAN et al, 2013;FERNANDES et al, 2014;LEE et al, 2015). However, due to the high prevalence of such otological complaints in individuals with masticatory muscle disorders, it is speculated that there is a close relationship between tinnitus and this kind of TMD (BUERGERS et al, 2014).…”

“…It is noteworthy that although the close relationship between the experience of myofascial pain and depression is accepted and reported in the scientific literature (DOHRENWEND et al, 2007), this association is still commonly disregarded in the clinical routine (FERNANDES et al, 2013). It is understood that the presence of depressive symptoms can contribute to the chronicity of TMD ( VELLY et al, 2011), mainly muscular, resulting indirectly in the plastic auditory changes that would be expressed by tinnitus, as a result of the interfering somatosensory impulses in the descending modulatory pathways (SALVINELLI et al, 2003).…”