Impact event and orofacial pain amid the COVID-19 pandemic in Brazil: a cross-sectional epidemiological study

Abstract Objectives This study aims to assess the impact of social isolation, due to the Covid-19 pandemic, on mental health, Temporomandibular Disorder (TMD) and orofacial pain in men and women. Methodology Individuals living in Brazil answered an online questionnaire on their sociodemographic and behavioral aspects, emotional scale (DASS-21), Impact of Event Scale, and Pain Screener in Temporomandibular Disorders (TMD-Pain Screener) during June 2020. Descriptive statistical analyses and logistic and linear regressions were applied (5% significance). Results Overall, 2301 individuals were included, 89.1% practiced social isolation, 72.6% were employed/studying, at least 15% presented severe or extremely severe levels of emotional distress and presence of powerful (34.1%) and severe impact event (15%). During the outbreak, 53.2% perceived feeling worse and 31.8% reported that orofacial pain started or worsened after the pandemic outbreak. Gender was associated with "social class" (P=0.036), "pain/stiffness in the jaw on awakening" (P=0.037), "change of pain during jaw habits" (P=0.034) and "perception of change in the situations mentioned in the TMD-Pain Screener" (P=0.020), "depression" (P=0.012), "anxiety" (P=0.006) and "impact of the event" (P=8.3E-11). Social isolation had a lesser chance to change the routine, to be practiced by the unemployed/not studying, and to be practiced by men (all with P<0.001). Associations were found between social class and all subscales of the DASS-21 and IES, all with P<0.001. Conclusions The practice of social isolation has social determinants. High levels of psychological and event impacts were detected. The presence of orofacial pain seemed to increase during the health crisis, and there were gender differences in the response to the COVID-19 pandemic.

Pain and temporomandibular disorders in patients with eating disorders

Abstract Orofacial pain and temporomandibular dysfunction may cause chronic facial pain, which may interfere with the emotional state and food intake of patients with eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN). Sixty-four patients were assigned to four groups: Group A (AN - restricting subtype): 07; Group B (AN - purging subtype ): 19; Group C (BN): 16; and Group D (control): 22. Complaints of pain are more prevalent in individuals with eating disorders (p<0.004). There are differences between the presence of myofascial pain and the number of hospitalizations (p = 0.046) and the presence of sore throat (p=0.05). There was a higher prevalence of masticatory myofascial pain and complaints of pain in other parts of the body in ED patients; however, there was no difference between ED subgroups. There was no difference in the number of self-induced vomiting between ED patients with and without myofascial pain.

Systemic diseases and other painful conditions in patients with temporomandibular disorders and migraine

Abstract Temporomandibular disorders (TMD) are a highly prevalent, painful musculoskeletal condition affecting the masticatory system, and are frequently associated with migraines (M) and other diseases. This study aimed to investigate the association between painful TMD and M with other painful conditions and systemic diseases, such as cervicalgia, body pain (BP), ear-nose-throat disorders, musculoskeletal disorders, diabetes, cardiopulmonary diseases and gastritis/peptic ulcer. Methods: This was a cross-sectional study conducted in a sample of 352 individuals. Participants were stratified into three groups according to the presence of painful TMD and M: controls [individuals free of TMD and any headache (HA)]; TMD only (presence of painful TMD, but free of any HA); and TMD+M (presence of painful TMD and M). TMD was classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I. Nonspecific physical symptoms (NSPS) were assessed by RDC/TMD - Axis II. The International Classification of Headache Disorders - II criteria, second edition, were applied to identify and classify primary HA. Other painful conditions and systemic diseases were assessed by volunteers' self-report. The prevalence of all assessed conditions was higher in the TMD+M group. Multiple regression models showed that cervicalgia was associated with the TMD only group (p<0.05), whereas gender (p<0.05), cervicalgia (p<0.05), BP (p<0.05) and NSPS (p<0.05) were significantly associated with the TMD+M group. Our results suggest that individuals with a comorbidity (TMD associated with M) have a more severe condition than those presenting only painful TMD.

Orotracheal intubation and temporomandibular disorder: a longitudinal controlled study / Intubação orotraqueal e disfunção temporomandibular: estudo longitudinal controlado

ABSTRACT BACKGROUND AND OBJECTIVES: To determine the incidence of signs and symptoms of temporomandibular disorder in elective surgery patients who underwent orotracheal intubation. METHODS: This was a longitudinal controlled study with two groups. The study group included patients who underwent orotracheal intubation and a control group. We used the American Academy of Orofacial Pain questionnaire to assess the temporomandibular disorder signs and symptoms one-day postoperatively (T1), and the patients' baseline status prior to surgery (T0) was also recorded. The same questionnaire was used after three months (T2). The mouth opening amplitude was measured at T1 and T2. We considered a pvalue of less than 0.05 to be significant. RESULTS: We included 71 patients, with 38 in the study group and 33 in the control. There was no significant difference between the groups in age (study group: 66.0 [52.5-72.0]; control group: 54.0 [47.0-68.0]; p = 0.117) or in their belonging to the female gender (study group: 57.9%; control group: 63.6%; p = 0.621). At T1, there were no statistically significant differences between the groups in the incidence of mouth opening limitation (study group: 23.7% vs. control group: 18.2%;p = 0.570) or in the mouth opening amplitude (study group: 45.0 [40.0-47.0] vs. control group: 46.0 [40.0-51.0];p = 0.278). At T2 we obtained similar findings. There was no significant difference in the affirmative response to all the individual questions in the American Academy of Orofacial Pain questionnaire. CONCLUSIONS: In our population, the incidence of signs and symptoms of temporomandibular disorder of muscular origin was not different between the groups.

RESUMO JUSTIFICATIVA E OBJETIVOS: Determinar a incidência de sinais e sintomas de disfunção temporomandibular (DTM) em pacientes de cirurgia eletiva submetidos à intubação orotraqueal. MÉTODOS: Estudo longitudinal controlado com dois grupos. O grupo de estudo incluiu pacientes que foram submetidos à intubação orotraqueal e um grupo controle. Usamos o questionário da Academia Americana de Dor Orofacial (AAOP) para avaliar os sinais e sintomas da DTM no primeiro dia de pós-operatório (T1) e os estados basais dos pacientes antes da cirurgia (T0) também foram registrados. O mesmo questionário foi usado após três meses (T2). A amplitude da abertura bucal foi medida em T1 e T2. Consideramos um valor p inferior a 0,05 como significativo. RESULTADOS: No total, 71 pacientes foram incluídos, com 38 pacientes no grupo de estudo e 33 no grupo controle. Não houve diferença significativa entre os grupos quanto à idade (grupo de estudo: 66 [52,5-72]; grupo controle: 54 [47-68], p = 0,117) ou gênero feminino (grupo de estudo: 57,9%; grupo controle: 63,6%, p = 0,621). No T1, não foram encontradas diferenças estatisticamente significativas entre os grupos quanto à incidência de limitação de abertura bucal (grupo de estudo: 23,7% vs. grupo controle: 18,2%, p = 0,570) ou amplitude de abertura bucal (grupo de estudo: 45 [40-47]vs. grupo controle: 46 [40-51], p = 0,278). Em T2, os resultados obtidos foram semelhantes. Não houve diferença significativa na resposta afirmativa a todas as perguntas individuais do questionário AAOP. CONCLUSÕES: Em nossa população, a incidência de sinais e sintomas de DTM de origem muscular não foi diferente entre os grupos.

Sinais e sintomas de desordem temporomandibular em mulheres e homens / Signs and symptoms of temporomandibular disorders in women and men

RESUMO Introdução: Mulheres são mais susceptíveis às desordens temporomandibulares (DTM), contudo, estudos que tenham comparado os gêneros em amostras brasileiras são raros. Objetivo: Analisar a proporção de homens e mulheres, bem como a associação entre o gênero e as variáveis idade, duração do problema e sintomas de DTM em pacientes admitidos para tratamento em uma clínica universitária. Métodos: Foram coletados e analisados dados de entrevista e avaliação de mil protocolos de pacientes com diagnóstico de DTM, divididos em 2 grupos, masculino (n=177) e feminino (n=823). Foi realizada a análise exploratória a partir de tabelas de contingência e teste do χ2. Posteriormente, foi utilizado o modelo de regressão logística e calculadas as odds ratio brutas (OR) referentes às comparações avaliadas. Resultados: Na amostra prevaleceu o gênero feminino e as médias de idade e de duração da DTM foram semelhantes entre os grupos, predominando a faixa etária de adultos jovens (19 a 40 anos). Os valores de OR evidenciaram associação entre o gênero feminino e os sinais/sintomas dor na articulação temporomandibular (ATM), dor nos músculos faciais, pescoço e ombros, cefaleia, fadiga nos músculos mastigatórios, sintoma otológico e disfonia, tendo sido a chance das mulheres os apresentassem duas vezes maior do que os homens. Conclusão: Na amostra de pacientes brasileiros com DTM foi maior o número de mulheres e essas apresentaram maior prevalência de sintomas dolorosos, seguidos pelos otológicos e queixas de disfonia. A prevalência de ruído articular foi semelhante nos grupos estudados.

ABSTRACT Introduction: Women are more likely to present temporomandibular disorders (TMD); however, studies comparing genders in Brazilian samples are rare. Purpose: To analyze the proportion of men and women, as well as the association between gender and age, problem duration, and TMD symptoms in patients admitted to an university clinic for treatment. Methods: Interview and assessment data of protocols from 1,000 patients diagnosed with TMD were collected and analyzed and then divided into two groups, male (n = 177) and female (n = 823). The exploratory analysis was based on contingency tables and χ2 test was carried out. Subsequently, the logistic regression model was used and the odds ratios (OR) concerning the evaluated comparisons were calculated. Results: Females were more prevalent in the sample, and mean ages and TMD duration were similar between the groups, with higher occurrence in young adults (19 to 40 years old). The OR values showed an association between the female gender and the signs/symptoms of pain in the temporomandibular joint, pain in the facial muscles, neck and shoulders, headache, fatigue in the muscles of mastication, otologic symptoms, and dysphonia. Women had two times higher chances of presenting these symptoms than men. Conclusion: In the sample of Brazilian patients with TMD, the number of women who presented a higher prevalence of painful symptoms was greater, followed by otologic symptoms and complaints of dysphonia. The prevalence of joint noise was similar in both studied groups.

Prevalence of temporomandibular disorders in postmenopausal women and relationship with pain and HRT

Abstract The prevalence of temporomandibular disorders (TMD) is higher in females, reaching their high peak during reproductive years, probably because of the action of some female hormones, which alter pain threshold. This study aimed to investigate the prevalence of TMD in postmenopausal women and its relationship with pain and hormone replacement therapy (HRT). In total, 284 patients were evaluated and classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Pain was measured using the Visual Analogue Scale (VAS), and patients were also asked about the use of HRT. All data was analyzed using analysis of variance (ANOVA) and chi-square test. In total, 155 subjects did not have TMD and 129 had TMD; TMD group patients were classified according to RDC/TMD axis I classification as follows: muscle disorder group (1.6%), disk displacement group (72.87%), and arthralgia, osteoarthritis, and osteoarthrosis group (37.98%). Pain was registered in 35 patients who belonged to the TMD group, while 48 patients reported the use of HRT. There was a similar percentage of TMD and non TMD patients; moreover, the use of exogenous hormones was no associated with TMD, suggesting that there is no influence on the pain threshold.

Prevalência de disfunção temporomandibular e associação com fatores psicológicos em estudantes de Odontologia / Prevalencia de trastornos temporomandibulares y su asociación con factores psicológicos en los estudiantes de Odontología / Prevalence of temporomandibular dsorders and association with psychological factors in students of undergraduate Dentistry students

Introdução: a abordagem dos fatores biopsicossociais tem ganhado destaque quando se analisa a natureza multifatorial da Disfunção Temporomandibular, mas alguns estudos trazem resultados conflitantes quanto à sua relação com fatores psicológicos. Objetivo: determinar a prevalência de sinais e sintomas desta disfunção e sua associação com a tensão emocional, ansiedade e depressão em estudantes universitários do curso de Odontologia. Métodos: do universo de acadêmicos de odontologia de uma universidade pública do nordeste brasileiro (344 estudantes), foram selecionados aleatoriamente 135 voluntários. Os critérios de exclusão foram: ausência de dois ou mais dentes (exceto os terceiros molares); uso de prótese removível; uso de aparelhos ortodônticos (fixo ou móvel), no momento do estudo; participantes em tratamento para disfunção ou outras dores orofaciais; não assinatura do termo de consentimento livre e esclarecido. Os sinais e sintomas de Disfunção Temporomandibular foram coletados através de uma ficha contendo um questionário anamnésico adaptado e de um protocolo de exame clínico. Para estimar a presença de fatores psicológicos foi utilizada a escala Hospital Anxiety and Depression, traduzida e validada para o português. Os dados foram tabulados e analisados descritiva e estatisticamente. Associações entre as variáveis, tensão emocional, ansiedade, depressão e disfunção foram verificadas pelos testes estatísticos Qui-quadrado (x2) e Exato de Fisher, com p< 0,05. Resultados: 76,3 porcento da amostra apresentaram disfunção, sendo que em 54,1 porcento esta foi considerada de grau leve, enquanto que em 22,2 porcento foi verificada necessidade ativa de tratamento. 34,1 porcento da amostra afetada apresentaram apenas sinais clínicos articulares. Tensão emocional foi estaticamente associada à presença de disfunção e a necessidade de tratamento. Ansiedade e depressão foram associadas apenas a necessidade de tratamento. Conclusão: a prevalência de Disfunção Temporomandibular na amostra de estudantes universitários foi elevada, com maior frequência de sinais clínicos articulares e associação com gênero feminino, tensão emocional, ansiedade e depressão(AU)

Introducción: el enfoque de los factores biopsicosociales tiene gran importancia en la naturaleza multifactorial de los trastornos temporomandibulares, pero algunos estudios presentan resultados contradictorios en cuanto a su relación con los factores psicológicos. Objetivo: determinar la prevalencia de signos y síntomas de este trastorno y su asociación con el estrés emocional, la ansiedad y la depresión en estudiantes de Odontología. Métodos: del universo de estudiantes de Odontología de una universidad pública en el noreste de Brasil (344 estudiantes) se seleccionaron 135 alumnos. Los criterios de exclusión fueron: ausencia de dos o más dientes (excluyendo los terceros molares); uso de prótesis desmontable; uso de aparatos de ortodoncia (fijo o móvil), en el momento del estudio; participantes en tratamiento para trastorno u otro dolor orofacial; no firmar el consentimiento informado. Los signos y síntomas del trastorno fueron recolectados a través de cuestionario y examen clínico. Para estimar la presencia de factores psicológicos se utilizó la escala Hospital Anxiety and Depression, traducida y validada para el portugués. Los datos fueron tabulados y analizados de forma descriptiva y estadística. Las asociaciones entre las variables, el estrés emocional, la ansiedad, la depresión y trastorno fueron verificadas por las pruebas estadísticas Chi Cuadrado (x2) y Exacta de Fisher (p< 0,05). Resultados: el transtorno se presentó em 76,3 por ciento de la muestra; en 54,1 por ciento fue considerado como leve, mientras que en 22,2 % fue verificada la necesidad de tratamiento. En 34,1 por ciento de la muestra afectada, solamente se presentaron signos clínicos articulares. El estrés emocional se asoció estadísticamente con el trastorno y la necesidad de tratamiento. La ansiedad y la depresión están asociados solo con la necesidad de tratamiento. Conclusión: la prevalencia de trastornos temporomandibulares en la muestra de estudiantes universitarios fue alta, con mayor frecuencia de signos clínicos articulares y asociados con el sexo femenino, el estrés emocional, la ansiedad y la depresión(AU)

Introduction: the approach of biopsychosocial factors have gained prominence when considering the multifactorial nature of Temporomandibular Disorders but some studies present conflicting results as to its relationship with psychological factors. Objective: to determine the prevalence of signs and symptoms of this disorder and its association with emotional stress, anxiety and depression in college students of Dentistry course. Methods: therefore, we randomly selected 135 volunteers from a Brazilian public university, from a total of 344 undergratuate dental students. Exclusion criteria were: absence of two or more teeth (excluding third molars); use of a removable prosthesis; use of orthodontic appliances (fixed or mobile), at the time of the study; participants treated for orofacial pain or dysfunction; not signing the free and informed consent. The signs and symptoms of temporomandibular dysfunction were collected through a form with an appropriate history questionnaire and a clinical examination protocol. To estimate the presence of psychological factors we used the scale Hospital Anxiety and Depression, translated and validated to Portuguese. Data were tabulated and analyzed descriptively and statistically. Associations between variables, emotional stress, anxiety, depression and dysfunction were verified by statistical tests chi-square (x2) and Fisher's exact, with p< 0.05. Results: 76.3 percent had dysfunction, and in 54.1 percent it was considered mild, while in 22.2 percent were observed active treatment needs. 34.1 percent of the sample had only affected joint clinical signs. Emotional tension is statically associated with the presence of disorder and need of treatment. Anxiety and depression are associated only with the need for treatment. Conclusion: the prevalence of Temporomandibular Disorders in the sample of college students was high, with higher frequency of joint clinical signs and associated with the female gender, emotional stress, anxiety and depression(AU)

Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic / Disfunção temporomandibular é mais prevalente entre pacientes com cefaleias primárias em um ambulatório de nível terciário

Objective The aim of this study was to estimate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with primary headaches attended in a tertiary neurology ambulatory.Method Authorized by the Ethics Committee, the present cross-sectional study was conducted with a random sample of patients screened for orofacial pain and primary headaches at a tertiary hospital in Northeast of Brazil.Results The sample consisted in 42 patients with primary headache, 59.5% male. The prevalence of > 6 TMD signs and symptoms was 54.8%. In those patients with migraine TMD was present in 71.4% and in tension-type headache in 38.1% (p = 0.030; OR = 4.1). TMD was related to the clinical status of headache associated or attributed to medication overuse (p = 0.001).Conclusion TMD has a high prevalence in patients with primary headaches (54.8%). Special attention must be given to patients with migraine and headache associated or attributed to medication overuse.

Objetivo Estimar a prevalência de sinais e sintomas de disfunção temporomandibular (DTM) e fatores associados em pacientes com cefaleias primárias atendidos em um ambulatório de neurologia.Método Autorizado pelo Comitê de Ética, o presente estudo transversal foi conduzido com uma amostra aleatória de pacientes investigados para dor orofacial e cefaleias primárias em um hospital terciário no nordeste do Brasil.Resultados A amostra consistiu em 42 pacientes com cefaleias primárias, sendo 59,5% homens. A prevalência de > 6 sinais e sintomas de DTM foi 54,8%. Naqueles pacientes com migrânea, DTM estava presente em 71,4% e em 38,1% daqueles com cefaleia do tipo tensional (p = 0,030; OR = 4,1). DTM foi relacionada à condição clínica de cefaleia por abuso de medicamentos (p = 0,001).Conclusão A DTM é uma condição com alta prevalência em pacientes com cefaleias primárias (54,8%). Atenção especial deve ser dada a pacientes com migrânea e cefaleia por abuso de medicamentos.

Prevalence of neuropathic symptoms in patients referred for temporomandibular disorder in a Chilean hospital, 2014-2015 / Prevalencia de síntomas neuropáticos en pacientes derivados por trastorno témporomandibular en un hospital chileno, 2014-2015

To determine the prevalence of neuropathic symptoms in the orofacial region in patients referred for painful temporomandibular disorder at Hospital Base Valdivia in 2014 and 2015. Materials and method: An observational study was conducted on patients referred for painful temporomandibular disorder by general dentists working in primary dental health care at Hospital Base Valdivia, during October 2014 and March and April 2015. Patients were asked to complete the LANSS pain scale by one of the examiners. The variables age, sex and location of pain were measured and registered. Results: Of the 84 patients surveyed, 88.1 percent were women, with a mean age of 38.2 years. The median score obtained with the LANSS scale was 3.0 [0-8.75]. A 20.2 percent had neuropathic pain symptoms. They were all women with an average age of 36.7. The most recurrent painful area was the right mandibular dermatome of the trigeminal nerve in patients with neuropathic pain symptoms. Conclusion: The prevalence of symptoms of neuropathic pain was 20 percent in patients referred for painful temporomandibular disorders. Dentists should evaluate neuropathic symptoms to provide a proper management of the condition...

Determinar la prevalencia de síntomas neuropáticos orofaciales en pacientes derivados por trastorno témporomandibular doloroso al Hospital Base Valdivia en 2014 y 2015. Material y métodos: Se desarrolló un estudio observacional incluyendo pacientes derivados por trastorno témporomandibular doloroso por odontólogos generales de atención primaria en salud, al servicio dental del Hospital, durante octubre del 2014, marzo y abril del 2015. Un examinador les aplicó la escala de dolor LANSS. Se midieron las variables edad, sexo y localización del dolor. Resultados: De los 84 pacientes encuestados, el 88.1 por ciento fueron mujeres, edad promedio de 38.2 años. La mediana del puntaje obtenido en la escala fue de 3.0 [0-8.75]. Un 20.2 por ciento presentó síntomas de dolor neuropático, todos mujeres, promedio de edad de 36.7 años. El dermatoma de la rama mandibular del nervio trigémino del lado derecho fue la zona dolorosa más frecuente en pacientes con síntomas de dolor neuropático. Conclusión: La prevalencia de síntomas de dolor neuropático es de un 20 por ciento en pacientes derivados por trastornos témporomandibulares dolorosos. Odontólogos deben considerar evaluar la presencia de síntomas neuropáticos para brindar un manejo adecuado...

Assessment of mandibular movements in 10 to 15 year-old patients with and without temporomandibular disorders

El objetivo del presente trabajo fue establecer valores de referencia de movimientos mandibulares en niños de 10-15 años sin disfunción; compararlos con los de pacientes de la misma edad con trastornos temporomandibulares (TTM) y con los hallados anteriormente en un grupo menor de 11 años sinTTM. Niños de ambos sexos que acudieron a la Cátedra Odontología Integral Niños de UBA en 2013 y cuyos responsables brindaron consentimiento fueron evaluados con CDI/TTM por odontopediatras estandarizados (Kappa 0.88) conformándose 3 grupos en función del resumen diagnóstico; C: sin TTM, Ia: con dolor miofacial e Ib: dolor con limitación de la apertura bucal, para el análisis de las siguientes variables: edad, sexo y movimientos mandibulares. La muestra quedó constituida por169 pacientes de 12.5±1.76 años. El 62.36 por ciento no presentó TTM (C) y en el 37.27 por ciento se estableció un diagnóstico de trastorno muscular (29.58 por ciento Ia y 7.69 por ciento Ib). En C se registraron lossiguientes valores en mm: Apertura máxima no asistida: 48.28±6.14; Lateralidad derecha 8.78±2.50; izquierda: 9.60±2.64; Protrusión: 4.94±2.58 y Sobremordida: 2.98 ± 2.5sin variaciones en relación al sexo, pero con diferencias en los registros de todos los movimientos comparados con losobtenidos en dentición mixta. (p=0.0001). El análisis de los valores medios de los movimientos mandibulares entre los 3 grupos sólo reveló diferencias para la apertura máxima no asistida (p= 0.0317). En relación al sexo, los TTM fueron másfrecuentes en niñas siendo significativa la diferencia entre C e Ia (p=0.019). En los niños sin disfunción se estableció unaapertura máxima promedio de 48.28±6.14mm, observándose valores inferiores en los pacientes con TTM. Los movimientos mandibulares en pacientes pediátricos sin TTM mostrarondiferencias significativas en función del tipo de dentición y la edad...

Prevalence of temporomandibular disorders symptoms in patients with multiple sclerosis / Prevalência de sintomas de Disfunção Temporomandibular em pacientes com Esclerose múltipla

The aim of the present study was to assess the prevalence of symptoms of temporomandibular disorders (TMD) in patients with the relapsing-remitting form of multiple sclerosis (MS), the relationship between TMD and the severity of MS, and the presence of TMD symptoms in the evaluated groups. Sixty individuals were evaluated: 30 patients diagnosed with relapsing-remitting MS and 30 control individuals matched for gender and age range with no neurologic pathology. In order to investigate the TMD symptoms, the questionnaires of the EACD (European Academy of Craniomandibular Disorders) and the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders), both validated for TMD research, were administered. To assess the extent of disability produced by MS, the Expanded Disability Status Scale (EDSS) was used. The prevalence of TMD symptoms in patients with MS was 56.7% versus 16.7% for the control group, with a statistically significant difference between the groups (p=0.0016). No correlation was found between the severity of MS and the prevalence of TMD symptoms (Fisher's test, p=1.0).

O objetivo deste estudo foi pesquisar a prevalência de sintomas de disfunção temporomandibular (DTM) em pacientes com esclerose múltipla (EM) na forma remitente-recorrente e sua relação com o grau de acometimento da doença e a presença de sintomas de DTM entre os grupos avaliados. Foram avaliados 60 indivíduos, sendo 30 com diagnóstico de EM e 30 controles pareados em gênero e faixa etária. Para avaliação de sintomas de DTM, foi aplicado o questionário recomendado aos clínicos pela Academia Europeia das Desordens Craniomandibulares . Para avaliação do nível de acometimento da EM foi utilizada a escala EDSS (Expanded Disability Status Scale). Os resultados da pesquisa mostraram que a prevalência de sintomas de DTM em pacientes com EM foi de 56,7% e 16,7% para o controle, havendo diferença estatística significativa entre os grupos. Não houve correlação entre o nível de acometimento pela EM e a prevalência de sintomas de DTM.

Degree of chronic orofacial pain associated to the practice of musical instruments in orchestra's participants.

Objective: The practice of playing musical instruments can affect structures of the head, neck, mouth, and the masticatory system. The aim of this study was to obtain information regarding the prevalence of orofacial pain in musicians according to the type of instrument they play, by applying a specific questionnaire. Materials and Methods: One hundred and seventeen musicians of Sao Paulo state's orchestras participated in this study. They answered an anamnesis questionnaire with 20 questions regarding their personal data, type of instrument played, hours of daily practice, and presence or absence of orofacial pain according to the Chronic Pain Grade Classification (CPGC). Musicians were divided into two groups in accordance with the risk of affecting TMJ: RG (risk group, including violin, viola, vocalist, trombone, tuba, clarinet and saxophone); CG (control group, other instruments). They received an informative brochure about the subject. Data obtained from the questionnaire were submitted to descriptive statistics, Pearson's correlation analysis and Z-test for difference between two proportions. Results: The participants were from 15 to 62 years old. Pain degree showed positive correlation for reported symptoms (P = 0.002) and hour/day practice (P = 0.030). Regarding the prevalence of pain degree, data were, for RG: Grade 0 (54.5%), Grade 1 (30.3%), and Grade ≥2 (15.1%). For CG, Grade 0 (84.4%), Grade 1 (8.9%), and Grade ≥2 (6.6%). Z-test showed positive difference between groups (P = 0.0001). Conclusion: It was concluded that the musicians of risk group presented higher prevalence of orofacial pain than control (non-risk) group.

Asimetrías faciales como factor etiopatogénico de cefaleas y dolor facial / Facial asymmetries as etiopathogenic factors of headache and facial pain

El objetivo de este estudio fue demostrar la hipótesis sobre la coexistencia de asimetría morfológica con actividad muscular asimétrica, y deesta última con disfunción cráneomandibular y cefalea tensional y dolor facial, para incorporar datos semiológicos al diagnóstico tempranoy tratamiento precoz de las disfunciones cráneo-cérvico mandibulares. Participaron del estudio 66 alumnos de la F.O.U.B.A. con signos y/o síntomas de disfunción cráneomandibular. El diagnóstico de dolor se realizó mediante cuestionarios siguiendo los criterios diagnósticos de la Internacional Headache Society. La determinación de asimetría se realizó midiendo segmentos y ángulos trazados en telerradiografíade frente para tejidos duros y fotografía de cara de frente para tejidos blandos. Se evaluó la función muscular mediante electromiografía de superficie (EMGS); y la dinámica del sistema estomatognático mediante el método magnetométrico. El análisis de regresión logística múltiple resultó significativo al nivel p=0.01. En el análisis de las variables individuales y el dolor se encontró correlación estadísticamente significativa entre la asimetría de tejidos duros y la presencia de cefalea tensional y/o dolor facial. El organismo intenta equilibrar las diferencias morfológicas, esto explicaría las asimetrías cruzadas entre tejidos duros, blandos y actividad muscular comocompensaciones funcionales. Concluimos diciendo que ante la presencia de cefalea tensional y/o dolor facial debemos considerar la asimetríafacial de tejidos duros como posible factor etiológico predisponente aunque no se observe asimetría en tejidos blandos por acción compensatoria de la dinámica muscular. La etiología mixta, oclusal y postural, de las asimetrías faciales requiere del trabajo interdisciplinario odontólogo-médico-kinesiólogo-psicólogo-fonoaudiólogo para un óptimo diagnóstico y tratamiento

The aim of this study was to test the hypothesis on the coexistence of morphological asymmetry with asymmetric muscle activity, and this one with craniomandibular dysfunction and tension headache and facial pain, to incorporate semiological data to early diagnosis and treatment for TMJD (temporo mandibular jaw dysfunction). Study participants were 66 students from the Faculty of Dentistry of the University of Buenos Aires with TMJD signs and / or symptoms. The diagnosis of pain was conducted by questionnaires following the diagnostic criteria of the International Headache Society. The asymmetry determination was performed by measuring segments and angles in cephalometric frontal tracings for hard tissues and frontal picture for soft tissues. Muscle function was evaluated by surface electromyography (SEMG) and stomatognathic system dynamics by magnetometric method. The multiple logistic regression analysis was significant at p = 0.01. In the analysis of individual variables and pain we found statistical correlation between the asymmetry of hard tissues and the presence of tension headache and / or facial pain. The body tries to balance the morphological differences; this would explain the asymmetries cross between hard tissues, soft and functional muscle activity as offsets. We conclude saying that in the presence of tension headache and/or facial pain, the hard tissue facial asymmetry should be considered as a possible etiologic factor predisposing even asymmetry is not observed in soft tissue because of compensatory action of muscle dynamics. The mixed etiology, occlusal and postural of the facial asymmetries, requires interdisciplinary work dentist-doctor-physiotherapist,-psychologist-speech therapist, for optimal diagnosis and treatment.

Prevalencia de dolor orofacial en la consulta máxilofacial del centro médico San Joaquín de la Pontificia Universidad Católica de Chile / Prevalence of orofacial pain in the maxillofacial consultation of the centro médico San Joaquin, Pontificia Universidad Catílica de Chile

Introducción: Los variados cuadros clínicos que cursan con dolor orofacial, así como las repercusiones en la calidad de vida y la economía, tanto de los pacientes como de los organismos de atención de salud, hace que éstos requieran de un manejo multidisciplinario. Objetivo: Determinar la prevalencia de dolor orofacial como motivo de consulta maxilofacial en el Centro Médico San Joaquín de la Pontificia Universidad Católica de Chile. Material y método: Estudio descriptivo-retrospectivo del total de primeras consultas de Cirugía Maxilofacial entre los años 2007 y 2010. Se obtuvieron características demográficas y clínicas, generales y específicas para dolor orofacial. Resultados: De un total de 818 pacientes, 245 consultas (30 por ciento) fueron por dolor orofacial, de las cuales 174 (71 por ciento) correspondieron a dolor orofacial músculoesquelético. Conclusiones: La prevalencia de dolor orofacial en nuestro estudio fue de un 30 por ciento, cifra que se encuentra dentro de lo estimado en la literatura (1 por ciento a 55 por ciento), destacando el dolor músculoesquelético como el más prevalente. Un enfoque multidisciplinario se hace necesario dada la complejidad de estos pacientes.

Introduction: The varied clinical conditions that present with orofacial pain, and the impact on quality of life and economy of both the patients and health care agencies, make these require a multidisciplinary management. Objective: To determine the prevalence of orofacial pain as the reason for maxillofacial consultation to Centro Médico San Joaquín, Pontificia Universidad Católica de Chile. Material and Method: Retrospective descriptive study of all first consultations of Maxillofacial Surgery between 2007 and 2010. Clinic and demographic characteristics were obtained.Results: Of a total of 818 patients, 245 (30 per cent) consultations were for orofacial pain, of which 174 (71 per cent) were for musculoskeletal orofacial pain. Conclusions: The prevalence of orofacial pain found is similar to that reported in the literature. We found a high prevalence of neuropathic pain in this study. Specialized multidisciplinary approach is necessary for the management of this type of pathology, given the complexity in both the diagnosis and treatment.

Prevalência da dor orofacial e seu impacto no desempenho diário em trabalhadores das indústrias têxteis do município de Laguna, SC / Prevalence of orofacial pain and its impact on the oral health-related quality of life of textile industries workers of Laguna, SC, Brazil

Foram examinadas as tendências em saúde da população idosa brasileira utilizando-se dados da Pesquisa Nacional por Amostra de Domicílios (1998-2008). O estudo incluiu uma amostra probabilística de 105.254 pessoas com > 60 anos de idade. A média da idade foi de 69 anos e 56 por cento eram mulheres. Houve um aumento gradativo da boa autoavaliação da saúde (39,3 por cento, 43,5 por cento e 45,0 por cento em 1998, 2003 e 2008, respectivamente) e uma diminuição na prevalência de artrite, doença do coração e depressão autorreferidas. A prevalência da hipertensão (43.9 por cento, 48.8 por cento e 53.3 por cento, respectivamente) e do diabetes autorreferidos (10.3 por cento, 13.0 por cento e 16.1 por cento respectivamente) aumentou acentuadamente. A prevalência da incapacidade para realizar atividades da vida diária (alimentar-se, tomar banho ou ir ao banheiro) permaneceu estável (6.5 por cento, 6.4 por cento e 6.9 por cento, respectivamente). A realização de três ou mais consultas médicas nos 12 meses precedentes aumentou 21 por cento entre 1998 e 2008. As hospitalizações diminuíram 10 por cento no mesmo período. Essas tendências foram independentes do sexo e da idade. Os resultados mostram melhora em algumas dimensões da saúde dos idosos, mas não em todas. As mudanças no uso de serviços de saúde ocorreram como esperado em decorrência da expansão das atividades de atenção primária no Brasil.

The aim of this study was to establish the prevalence of orofacial pain and its impact on the daily performance of workers in the textile industry in the municipality of Laguna, Brazil. A cross-sectional study involving all workers (n= 267) of the five textile industries of the municipality in 2004 was conducted. Data were obtained through the questionnaire proposed by Locker and Gruska to measure the Oral Impact on Daily Performance (OIDP) indicator. Socio-demographic data such as gender, age, level of schooling, income, job function and absenteeism due to orofacial pain was collected. Data were descriptively analyzed and the prevalence ratios, confidence intervals and unconditional multiple logistic regression were calculated. The prevalence of orofacial pain was 32.2 percent and the oral impact on daily performance was 28.5 percent. The regression model indicated that orofacial pain was the only variable statistically associated with the oral impact on daily performance, increasing its prevalence by more than 22 times, compared to those without orofacial pain. It was concluded that the prevalence of orofacial pain was high among workers, representing a decisive factor on the oral impact on daily performance.

Prevalencia de dolor orofacial en la unidad de dolor y cuidados paliativos del Hospital Clínico de la Universidad de Chile / Prevalence of orofacial pain in the pain and paliative care unit, Hospital Clínico de la Universidad de Chile

Introducción: Debido a los variados cuadros clínicos que cursan con dolor orofacial, así como las repercusiones en la calidad de vida y la economía, tanto de los pacientes como de los organismos de atención de salud, hace que estos requieran de un manejo multidisciplinario. Objetivo: Determinar la prevalencia y las características epidemiológicas y clínicas de las consultas por dolor orofacial en la Unidad de Dolor y Cuidados Paliativos del Hospital Clínico de la Universidad de Chile. Material y método: Estudio descriptivo-retrospectivo de los pacientes con diagnóstico de dolor orofacial ingresados a la Unidad en el período comprendido entre enero de 2003 y mayo de 2011. Se obtuvieron características demográficas y clínicas. Resultados: De un total de 1.125 pacientes, encontramos una prevalencia de 10,5 por ciento (118) de pacientes con diagnóstico de dolor orofacial, con una edad promedio de 57,8 +/- 15,2 años. En este grupo un 81 por ciento (95) de los pacientes fueron de sexo femenino. Las agrupaciones de diagnósticos más prevalentes fueron dolor neuropático (55 por ciento), músculo-esquelético (25 por ciento), psicógeno (11 por ciento), dolor neurovascular (5 por ciento); dolor oncológico(3,3 por ciento); dolor facial odontogénico (0,7 por ciento).Conclusiones: La prevalencia de dolor orofacial encontrada es similar a la reportada en la literatura, encontrándose una alta prevalencia de dolor neuropático en nuestro estudio. Es necesario un manejo especializado en este tipo de patología, dada la complejidad tanto en el diagnóstico como en el manejo.

Introduction: Because of the varied clinical conditions that present with orofacial pain, and the impact on quality of life and economy of both the patients and health care agencies, makes these require a multidisciplinary management. Objective: To determine the prevalence, epidemiologic and clinic characteristics of consultation regarding orofacial pain in the Pain and Palliative Care Unit, Hospital Clínico de la Universidad de Chile. Material and Method: Descriptive retrospective study inpatients who have been diagnosed with orofacial pain and treated at the Unit from January 2003 to May 2007. Clinic and demographic characteristics were obtained. Results: From a total of 1125 patients, we found a prevalence of10,5 percent (118) of patients with orofacial pain, with an average age of 57,8 +/- 15,2 years. In this group 81 per cent (95) of the patients were female. The most prevalent diagnosis groups were neuropathic pain (55 percent), musculoskeletal (25 percent) and psychogenic (11 percent).Conclusions: The prevalence of orofacial pain found is similar to that reported in the literature, found a high prevalence of neuropathic pain in this study. Is necessary specialized management of this type of pathology, given the complexity in both the diagnosis and treatment.

Prevalence of temporomandibular disorders and orofacial pain in battered women in Brazilian shelters / Prevalência de desordens temporomandibulares e de dor orofacial em mulheres vítimas de violência

PURPOSE: To assess the prevalence of Temporomandibular Disorders (TMD) and Orofacial Pain (OFP) in women victim of domestic violence, and the impact of chronic pain in related psychosocial factors, such as depression and somatization, as well as in the women's quality of life. METHODS: A convenience sample of 20 women in a situation of domestic violence who accessed support institutions were voluntarily interviewed. OFP and related psychosocial factors were assessed by using the RDC/TMD (Research Diagnostic Criteria for TMD) Axis II, and the history of physical and sexual abuse by the S/PAHQ (Sexual and Physical Abuse History Questionnaire). RESULTS: Eighty percent of women victim of violence showed chronic pain, varying from 1 to 3 on a four-point scale (0 to 3), 65 percent showed severe depression, and 60-70 percent reported evere somatization with or without pain, respectively. In addition, 85 percent reported pain in the face, temples and ear in the last month with a recurrent pattern. CONCLUSION: Data indicated high prevalence of TMD and OFP in this sample. There is a need for qualification of health professionals dealing with abused women in order to identify the presence of TMD and OFP as well as depression and somatization.

OBJETIVO: Os objetivos deste estudo foram o de avaliar a prevalência de Disfunção Têmporo-Mandibular e Dor Orofacial (DTM e DOf) em mulheres vítimas de violência, e o impacto da dor crônica nos fatores psicossociais relacionados, como depressão e somatização, e na qualidade de vida das mulheres. METODOLOGIA: Uma amostra de conveniência de 20 mulheres em situação de violência doméstica que acessam instituições de apoio foram entrevistadas volutariamente. A dor orofacial e fatores psicossociais relacionados foram avaliados pelo RDC/DTM (Critério de Diagnóstico para Pesquisa das Desordens Temporomandibulares) Eixo II, e a história de abuso físico e social pelo S/PAHQ (Questionário sobre História de Abuso Físico e Sexual). RESULTADOS: Oitenta por cento das mulheres vítimas de violência mostraram dor crônica, variando de 1 a 3 em uma escala de quarto ítens (0 to 3), 65 por cento demonstraram depressão severa, e 60 e 70 por cento, somatização severa com ou sem dor, respectivamente. Adicionalmente, 85 por cento relataram dor na face, têmporas e ouvido no ultimo mês com uma padrão recorrente. CONCLUSÃO: Os dados indicaram alta prevalência de DTM e DOf nesta amostra. Há necessidade de qualificação de profissionais de saúde que atendam mulheres agredidas a fim de identificar a presença de DTM e DOf, bem como depressão e somatização.

prospective study of mobile phone user complaints in Saudi Arabia

To study the long-term effects of mobile phone exposure in regard to ear pain and pressure, facial pain, headache, hearing loss, tinnitus, vertigo, and hotness. Four hundred volunteer subjects who used mobile phones were recruited, 313 subjects completed 2 years follow up. The cheif complaints were ear pressure [42.0%], headache [38.1%], and hotness [36.2%]. Whereas only 17.9% of subjects had 1 complaint, 20.9% had 3 complaints. Forty-eight subjects [15.9%] had no primary complaints, but complained of a variety of minor symptoms, including anxiety, numbness, a heavy sensation, or itchiness. Six subjects had to reduce mobile phone usage and 9 had to stop using a mobile phone altogether. Bivariate correlation analysis of the 8 primary complaints revealed only 3 pairs that had a phi coefficient of above 0.3: headache and facial pain: 0.339, p < .000001; headache and hearing loss: 0.413, p <.000001; and headache and vertigo: 0.325, p <.000001. There was no evidence of a dose-response relationship between call duration and complaints

Incidence of orofacial pain in patients of Fallujah city/ AL-Anbar-Iraq

Orofacial pain is a common complaint and represents a challenging diagnostic problem. It includes both oral and facial components, like teeth and associated structures, followed by oral mucosa. The aim of the study is to report the causes of orofacial pain [OFF] in Fallujah. the sample of this study included [269 patients] attending the medical centre in Fallujah city with complaining from orofacial pain. In this study the most causes of OFF is dental origin that include 24[8.9%] of cases with acute apical periodentitis and 71[26.4%] with acute apical abscess; pulpitis in 56[20.8%]; acute gingivitis in 70 [26.0%]; periocoronitis in 29 [10.8%]; dry socket in 8 [3.0%]; denture trauma in 2 [0.7%]; cellulites in 4[1.5%]; chronic apical abscess in 1[0.4%]; whereas other causes were migraine in 2 [0.7%]; TMJ disorder in 1[0.4%] and psychological pain in 1[0.4%].OFF derives from a vast number of complex etiologies and majority of the causes was odontogenic origin [98.5%] while the minority is due to nonodotogenic origin [1.5%] and the acute pain has been significantly higher [about 97.4%] than chronic pain [about 2.6%]

Prevalence of signs and symptoms of temporomandibular disorders in children in the state of Puebla, Mexico, evaluated with the research diagnostic criteria for temporomandibular disorders (RDC/TMD)

The aim of this work was to describe the prevalence of signs and symptoms of temporomandibular disorders (TMD) in children of the State of Puebla, Mexico. A descriptive observational study was performed. After calculating sample size, children who met the following selection criteria were included: registered at an official elementary school, either sex, ages between 8 and 12 years, who accept to participate in the study and whose parents have signed the informed consent forms. The Research Diagnostic Criteria for Temporomandibular Disorders were used by calibrated researchers (Kappa.90) under the same conditions. Descriptive statistics were applied by using SPSSv15 software. The study included 235 children, 129 (54.9%) female and 106 (45.1%) male, of average age 9.31+1.2 years. Prevalence of signs and symptoms was 33.2%, and predominately muscular (82%), 48.1% showed signs of muscular pain and 19.1% joint pain. 63.4% showed signs of alteration in the mouth opening pattern, 39.1% presented joint sounds on opening or closing the mouth and 20.4% on mandibular excursions. The high prevalence of signs and symptoms related to temporomandibular disorders, in particular in children with mixed dentition, shows the importance of TMD evaluation during this period, when morphological changes associated to growth and craniofacial development prevail.

El objetivo del presente trabajo fue describir la prevalencia de signos y sintomas de los trastornos temporomandibulares (TTM) en ninos del estado de Puebla, Mexico. Se realizo un estudio observacional descriptivo. Previo calculo de tamano de muestra, se incluyeron ninos que cumplieron con criterios previos de seleccion: inscriptos en escuela primaria oficial, de cualquier sexo, en edades de 8 a 12 anos, que aceptaron participar en el estudio y cuyos padres firmaron el consentimiento informado. Se utilizaron los Criterios de Investigacion Diagnostica para los TTM, aplicados por investigador estandarizado (Kappa .90) bajo las mismas condiciones. Se calculo estadistica descriptiva con el programa SPSS v15. Se incluyeron 235 ninos, 129 (54.9%) mujeres y 106 (45.1%) varones con promedio de edad de 9.31}1.2 anos. La prevalencia de signos y sintomas de TTM fue del 33.2% predominantemente musculares (82%), 48.1% presentaron dolor muscular y 19.1% articular. El 63.4% presento alteraciones en el patron de apertura bucal, 39.1% presento ruidos articulares en apertura o cierre y 20.4% a las excursiones mandibulares. Las altas prevalencias de los signos y sintomas relacionadas con los Trastornos Temporomandibulares, particularmente en ninos con denticion mixta, demuestran la importancia de la evaluacion de los TTM durante este periodo, donde prevalecen los cambios morfologicos asociados al crecimiento y al desarrollo craneofacial.