Peer Review #3 of "Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw? (v0.2)"

Background Patients with chronic orofacial pain due to temporomandibular disorders (TMD) display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. Methods TMD patients with chronic unilateral orofacial pain (n = 20) and matched healthy volunteers (n = 20) performed a temporal order judgment (TOJ) task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. Results TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance (p = .07). In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. Discussion The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a reason for this. The findings are discussed within recent theories of pain-related attention.

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Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000500021 ◽

2008 ◽

Vol 66 (3b) ◽

pp. 716-719 ◽

Cited By ~ 15

Author(s):

Adriana Ronchetti de Castro ◽

Silvia Regina Dowgan Tesseroli de Siqueira ◽

Dirce Maria Navas Perissinotti ◽

José Tadeu Tesseroli de Siqueira

Keyword(s):

Trigeminal Neuralgia ◽

Orofacial Pain ◽

Temporomandibular Disorder ◽

Daily Activities ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Helpful Factors ◽

High Level ◽

Anxiety Depression ◽

Had Scale

OBJECTIVE: To determine the psychological aspects of orofacial pain in trigeminal neuralgia (TN) and temporomandibular disorder (TMD), and associated factors of coping as limitations in daily activities and feelings about the treatment and about the pain. METHOD: 30 patients were evaluated (15 with TN and 15 with TMD) using a semi-directed interview and the Hospital Anxiety Depression (HAD) scale. RESULTS: TN patients knew more about their diagnosis (p<0.001). Most of the patients with TN considered their disease severe (87%), in opposite to TMD (p=0.004); both groups had a high level of limitations in daily activities, and the most helpful factors to overcome pain were the proposed treatment followed by religiosity (p<0.04). Means of HAD scores were 10.9 for anxiety (moderate) and 11.67 for depression (mild), and were not statistically different between TMD and NT (p=0.20). CONCLUSION: TN and TMD had similar scores of anxiety and depression, therefore patients consider TN more severe than TMD. Even with higher limitations, patients with TN cope better with their disease then patients with TMD.

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Temporomandibular disorder and other causes of orofacial pain: first international classification and new treatment perspectives

Medical alphabet ◽

10.33667/2078-5631-2019-4-35(410)-40-46 ◽

2020 ◽

Vol 4 (35) ◽

pp. 40-46

Author(s):

N. V. Latysheva ◽

E. G. Filatova ◽

Al. B. Danilov ◽

R. R. Parsamyan ◽

E. A. Salina

Keyword(s):

Trigeminal Neuralgia ◽

Orofacial Pain ◽

Behavioral Therapy ◽

Temporomandibular Disorder ◽

International Classification ◽

Pharmacological Treatments ◽

Treatment Resistant ◽

New Treatment ◽

Correct Understanding

The diagnosis and treatment of orofacial pain is in many cases a complex task due to difficulties in history taking, multi‑faceted pathology, psychiatric comorbidities and psychosocial factors involved in such pain. Neurologists tend to overdiagnose trigeminal neuralgia. However, other types of neuropathiс orofacial pain are also common. Moreover, neurologists are often unfamiliar with the temporomandibular disorder and tend to neglect this extremely prevalent cause of orofacial pain. Correct understanding of the causes of orofacial pain is vital not only for treatment selection, but also to minimize the risk of adverse events associated with unnecessary madications. Moreover, untreated orofacial pain often becomes chronic and treatment resistant. Many patients in this case would require physical therapy, pharmacological treatments, cognitive behavioral therapy and other support options. The aim of this paper is to review the new International classification of orofacial pain as well as the prevalence, pathophysiology and treatment of the temporomandibular disorder, trigeminal neuralgia, persistent idiopathic facial pain, burning mouth syndrome and other forms of orofacial pain.

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Prevalence of Sign and Symptoms of Temporomandibular Joint Disorders in Pakistani Population at Sheikhupura, Lahore: A Gender comparison

10.53350/pjmhs211582166 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2166-2168

Author(s):

Ashfaq-ur- Rahim ◽

Muhammad Nauman ◽

Sadiq Ali ◽

Saima Ihsan ◽

Tannaza Qayyum ◽

...

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Orofacial Pain ◽

Temporomandibular Disorder ◽

Signs And Symptoms ◽

Temporomandibular Joint Disorders ◽

Female Ratio ◽

Pakistani Population ◽

Female Predominance ◽

History Of

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

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Temporomandibular disorder in otolaryngology: systematic review

The Journal of Laryngology & Otology ◽

10.1017/s0022215116009191 ◽

2016 ◽

Vol 131 (S1) ◽

pp. S50-S56 ◽

Cited By ~ 7

Author(s):

L Stepan ◽

C-K L Shaw ◽

S Oue

Keyword(s):

Systematic Review ◽

Health Professionals ◽

Pharmacological Treatment ◽

Orofacial Pain ◽

Temporomandibular Disorder ◽

Diagnostic Challenge ◽

Detailed Evaluation ◽

Examination Techniques ◽

Missed Diagnosis ◽

Disorder Treatment

AbstractBackground:Temporomandibular disorder poses a diagnostic challenge to otolaryngologists as orofacial pain, headache and otology symptoms are very common in temporomandibular disorder, and mimic a number of otolaryngological conditions. Missed diagnosis of temporomandibular disorder can lead to unnecessary investigation and treatment, resulting in further patient suffering.Objectives:To review the current literature and propose management pathways for otolaryngologists to correctly differentiate temporomandibular disorder from other otolaryngological conditions, and to initiate effective treatment for temporomandibular disorder in collaboration with other health professionals.Method:A systematic review using PubMed and Medline databases was conducted, and data on temporomandibular disorder in conjunction with otolaryngological symptoms were collected for analysis.Results:Of 4155 potential studies, 33 were retrieved for detailed evaluation and 12 met the study criteria. There are questionnaires, examination techniques and radiological investigations presented in the literature to assist with distinguishing between otolaryngological causes of symptoms and temporomandibular disorder. Simple treatment can be initiated by the otolaryngologist.Conclusion:Initial temporomandibular disorder treatment steps can be undertaken by the otolaryngologist, with consideration of referral to dentists, oral and maxillofacial surgeons, or physiotherapists if simple pharmacological treatment or temporomandibular disorder exercise fails.

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