scholarly journals Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Alexandra Dimitrijevic Carlsson ◽  
Kerstin Wahlund ◽  
Erik Kindgren ◽  
Thomas Skogh ◽  
Carin Starkhammar Johansson ◽  
...  

Abstract Background The aim of this study was to investigate relations between psychosocial factors, signs and symptoms of orofacial pain and jaw dysfunction in patients with juvenile idiopathic arthritis (JIA). Methods Forty-five patients with JIA (median age 12 years) and 16 healthy matched controls (median age 13 years) were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered the DC/TMD questionnaires regarding psychosocial factors (pain intensity, pain–related disability, depression, stress, catastrophizing, pain locations and jaw function). Results JIA patients with orofacial pain had higher degree of stress, depression, catastrophizing and jaw dysfunction compared to subjects without. In turn, these factors were associated with orofacial pain intensity. Also, patients with orofacial pain had higher systemic inflammatory activity. Conclusions Orofacial pain in patients with JIA is associated with stress, psychological distress, jaw dysfunction and loss of daily living activities. Pain intensity seems to be the major pain aspect related to these factors. In addition, systemic inflammatory activity appears to be an important factor contributing to orofacial pain in JIA.

2021 ◽  
Vol 15 (8) ◽  
pp. 2166-2168
Author(s):  
Ashfaq-ur- Rahim ◽  
Muhammad Nauman ◽  
Sadiq Ali ◽  
Saima Ihsan ◽  
Tannaza Qayyum ◽  
...  

Background: Temporomandibular disorders have been considered as a common orofacial pain condition. The term temporomandibular pain dysfunction (TMPD) is used synonymously with myofacial pain dysfunction disorder/syndrome, temporomandibular disorder, craniomandibular disorder and many other terms. Objective: To evaluate the prevalence of signs and symptoms of temporo-mandibular joint disorder (TMD). Study Design: Descriptive cross-sectional study Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Faryal Dental College, Sheikhupura , Lahore, Pakistan from 1st February 2019 to 31st May 2021. Methodology: One hundred adolescents aged 15 to 60 years were enrolled. A detailed history about the chief complaint was taken and clinical examination was done. Temporomandibular joint examination performed included Auscultation for temporomandibular joint sounds like clicking and crepitus and palpation of both TMJs and associated muscles for evaluation of pain. Results: The most common signs of temporomandibular joint disorders were temporomandibular joint pain 78%, temporomandibular joint clicking 53% and trismus 29%. The most prevalent predisposing factors of temporomandibular joint disorders were parafunctional habits 40%, unknown factors 23% and history of road traffic accident/history of difficult extractions 9%. Male to female ratio showed female predominance (P = 0.001). Conclusion: Signs and symptoms of temporomandibular joint disorders were prevalent in Pakistani population with a clear female predominance. Key words: Temporomandibular disorders, Temporomandibular joint, Orofacial pain, Bruxism, Headache, Pain


2021 ◽  
Vol 2 ◽  
Author(s):  
Sofia Louca Jounger ◽  
Nikolaos Christidis ◽  
Britt Hedenberg-Magnusson ◽  
Thomas List ◽  
Peter Svensson ◽  
...  

Background: The aim of this study was to investigate if single nucleotide polymorphisms (SNPs) related to monoaminergic neurotransmission, in particular the serotonergic pathway, contribute to pain perception in patients with temporomandibular disorder (TMD) myalgia and if there is a correlation to jaw function as well as psychosocial factors such as stress, anxiety and depression.Materials and Methods: One hundred and seventeen individuals with TMD myalgia were included. A venous blood or saliva sample was taken for genetic analyses and genotyped regarding HTR2A (rs9316233) HTR3A (rs1062613), HTR3B (rs1176744), SERT (5-HTTLPR) and COMT (rs4680). A clinical examination according to Diagnostic Criteria for TMD (DC/TMD) was performed and axis II data (psychosocial factors) were compared between participants with different genotypes for each gene using Kruskall–Wallis test. The characteristic pain intensity (CPI) was tested for correlations to scores for the Perceived Stress Scale, Generalized Anxiety Disorder, and Patient Health Questionnaires using Spearman's rank correlation test with Bonferroni correction for multiple testing. To further explore data factor analysis was performed to identify latent factors associated to the outcome variables.Results: Participants carrying at least one copy of the rare allele of the HTR2A (rs9316233) and HTR3A (rs1062613) had higher CPI compared with the participants with the homozygous common genotype (P = 0.042 and P = 0.024, respectively). Correlation analyses showed several significant positive correlations between CPI on one hand, and self-reported psychosocial distress and jaw function on the other hand for several genotypes that mostly were weak to moderate. The factor analysis identified two latent variables. One was positively correlated to the HTR3B gene, jaw function and self-reported parafunctions, and the other was positively correlated to psychological distress and negatively correlated to SERT.Conclusion: Taken together, the polymorphism rs1062613 in the HTR3A gene contributes to pain intensity in TMD myalgia. This together with positive interactions between pain variables and psychological factors in genotypes strengthens that pain and psychological distress are related. Further research is needed to explore this as well as the influence of gene-to-gene interactions on pain and psychological distress.


Cephalalgia ◽  
2021 ◽  
pp. 033310242110292
Author(s):  
Fernando G Exposto ◽  
Nicole Renner ◽  
Karina H Bendixen ◽  
Peter Svensson

Aim Headache attributed to temporomandibular disorders and myalgia are two diagnoses included in the diagnostic criteria for temporomandibular disorders (DC/TMD). However, it is not clear if these two diagnoses are different clinical entities given their similar presentation and way in which they are diagnosed, when the myalgia is within the temporalis muscle. The purpose of this retrospective study was to assess the overlap between headache attributed to temporomandibular disorders and myalgia of the temporalis muscle. Methods The charts of 671 patients seeking treatment at the Section of Orofacial Pain and Jaw Function, Aarhus University, Denmark, between January 2015 and February 2020 were screened for a diagnosis of headache attributed to temporomandibular disorders, myalgia of the temporalis muscle, or both. Results A total of 89 patients fulfilled the DC/TMD criteria for either headache attributed to TMD, myalgia of the temporalis or both. Of these, two had a diagnosis of headache attributed to TMD, 16 of myalgia of the temporalis, and 71 were diagnosed with both. In 97.3% of the times that headache attributed to temporomandibular disorders was diagnosed, the patient was also diagnosed with myalgia of the temporalis. The Jaccard index was 0.8, indicating a substantial overlap between the two diagnoses. Finally, the overlap of pain location between the two diagnoses was substantial, with a Jaccard index of 0.9. Conclusions In the present study, headache attributed to temporomandibular disorders was almost exclusively diagnosed together with myalgia of the temporalis. Therefore, we propose that headache attributed to temporomandibular disorders and myalgia of the temporalis muscle have more clinical similarities than differences and as such could be considered one single clinical entity. Further studies will be needed to address the clinical consequences of this proposal.


2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Simone Saldanha Ignacio de Oliveira ◽  
Sergio Luiz Melo Gonçalvez ◽  
Karin De Mello Weig ◽  
Thales Ribeiro Magalhães Filho ◽  
Omar Efrain Roque Martinez ◽  
...  

Background: Temporomandibular disorder (TMD) belongs to a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, musculature and adjacent components. These conditions can generate signs and symptoms and be influenced by an altered biopsychosocial condition. Objective: This study aims to seek information to assist the patient in the presence of TMD signs and symptoms and Orofacial Pain, associated with the period of social isolation during the COVID-19 pandemic. Material and methods: For the preparation of this manual, a bibliographic search was performed in the databases PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), BBO (BVS), Scopus, Web of Science and The Cochrane Library, using the keywords: orofacial pain, temporomandibular disorders, bruxism, stress, anxiety, biopsychosocial, diagnosis, self-care with important information on how to reduce and control the signs and symptoms of TMD and Orofacial Pain in this moment of pandemic that we are experiencing a social detachment. Results: The results show that the pandemic of COVID-19 and the need for social isolation, generates psychological impact that raises the pattern of anxiety and can directly affect patients with bruxism and TMD. Conclusion: Psychological factors associated with the pandemic can lead to an increased risk of developing, worsening and perpetuating bruxism, especially waking bruxism and TMD, so dentists should be aware of the occurrence of signs and symptoms to manage the multifactorial aspects of this condition. At that time, individual self-management strategies are advised for the patient, which consist of self-massage techniques, body education, exercise practices, sleep hygiene, meditation and making available the use of tools and online devices that facilitate this activity.KeywordsOrofacial pain; Temporomandibular disorders; Bruxism; Stress; Anxiety; Biopsychosocial; Diagnosis; Self-care; COVID-19.


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