Temporomandibular disorder subtypes according to self‐reported physical and psychosocial variables in female patients: a re‐evaluation

Abstract

Several studies support the relevance of psychological and psychosocial factors in the assessment and management of chronic musculoskeletal pain disorders, including temporomandibular pain disorders (TMDs). The aim of this study was to re-evaluate subtyping approach used in an earlier study (TI Suvinen, KR Hanes, JA Gerschman, PC Reade. J Orofac Pain 1997;11:200) and to compare perceived physical symptoms, psychological, coping and psychosocial variables between subtypes of patients who seek treatment for their temporomandibular pain and dysfunction. A total of 41 consecutive female patients were assessed multiaxially for physical symptoms, coping style and effectiveness and illness behaviour by a previously validated Temporomandibular Pain Dysfunction Questionnaire (TI Suvinen, KR Hanes, JA Gerschman, PC Reade. J Orofac Pain 1997;11:200). Additional measures of psychosocial variables included the global scores of the Beck Depression and Anxiety Inventory and Part I of the Multidimensional Pain Inventory. Subtypes were generated using an iterative partitioning method, k-means cluster analysis. Three clusters were identified and termed as Simple (22%), Intermediate (41%) and Complex (37%) temporomandibular disorders subtypes. Significant differences (P < 0.05) were found between clusters in psychological (coping style and effectiveness, disease conviction and affective disturbance) and in psychosocial variables (daily interference and social, work and family satisfaction), but not between physical variables. The results support previous studies that have shown differences in psychosocial variables in the presentation and subtyping of TMDs and the biopsychosocial orientation in assessment. The findings need to be reverified in a larger sample along specific physical diagnoses, but it is tentatively proposed how the three subtypes could be used in the classification of temporomandibular pain patients to guide management, based on the constellation of predominant psychological and psychosocial illness impact variables.

Comparison of perceived oral health in patients with temporomandibular disorders and dental anxiety using oral health-related quality of life profiles

“…In TMD patients, associations with depression [11,12], somatization [12,13], and stress [14] have been observed. Furthermore, measures of functional impact, disability, and handicap have demonstrated a considerable psychosocial burden in TMD patients [15]. Distinctive dental anxiety has been found to be most likely to develop in those who already suffer from other psychiatric diagnoses [13,16] and individuals of lower socioeconomic status [17].…”

Temporomandibular Disorder Awareness of Patients

“…3 Ayrıca, oklüzal ilişki, bruksizm gibi parafonksiyonlar, travma, hipermobilite, stres, kişilik, yaş, cinsiyet, kalıtım ve sistemik hastalıklar gibi birçok faktör de TMD'ye yol açabilmektedir.…”

“…[2][3][4][5] Genel populasyonda, dental kaynaklı problemlere bağlı olmayan orofasiyal ağrılar ve baş ağrısı, TMD varlığının en yaygın göstergesi ve önemli bir sağlık problemidir. 6 TMD'nin en sık görülen belirtileri; çiğneme kaslarında sertleşme ve yorgunluk (%19), baş ağrısı (%17), fonksiyon sıra-sında kaslarda ağrı (%11), TME sesleri (%8), alt çene hareketlerinin sınırlanması (%6), mandibulada kilitlenme (%4) ve kulak ağrısıdır (%4).…”

Stress, Stressverarbeitung und kraniomandibuläre Dysfunktionen

“…Neben der Konzeption von Stress über kritische Lebensereignisse [1] als Reiz für den Organismus sind Stressverarbeitungsstrategien als Reaktion des Organismus entscheidende modulierende Elemente für die Ausbildung von CMD [7,23,25,28]. Die Konzeption von Stress über kritische Lebensereignisse hat eine lange Tradition und gute empirische Evidenz.…”