Oral medicine
Prevalence of temporomandibular disorders in fibromyalgia and failed back syndrome patients: A blinded prospective comparison study

https://doi.org/10.1016/j.tripleo.2007.01.012Get rights and content

Objectives

The objective of this study was to determine the prevalence of temporomandibular disorders (TMD) and evaluate psychosocial domains in patients with fibromyalgia (FM) compared with patients with failed back syndrome (FBS).

Study design

The study included 51 (32 FM and 19 FBS) adult patients who were administered orofacial pain and psychological questionnaires before a clinical examination. Presence of TMD was diagnosed according to the Research Diagnostic Criteria for TMD.

Results

Fifty-three percent of the FM patients reported having face pain compared with 11% of the FBS patients. Of those FM patients who reported face pain, 71% fulfilled the criteria for a diagnosable TMD. FM patients had significantly higher subscale scores for somatization, obsessive-compulsive, medication used for sleep, and fatigue compared with FBS patients. Eighty-seven percent of the FM patients reported a stressful event and 42.3% had symptoms indicating posttraumatic stress disorder.

Conclusion

The high prevalence of TMD and psychosocial dysfunction among FM patients suggests wide-reaching dysregulation of autonomic and hypothalamic-pituitary-adrenal axis functions.

Section snippets

Participants

This was a prospective study that involved recruiting patients visiting the Physical Medicine and Rehabilitation Clinic and patients visiting a FM workshop organized by the Center for the Advancement of Women’s Health at the University of Kentucky between March 2005 and April 2006. The research was approved by the Institutional Review Board for the Protection of Human Patients. The study sample included 32 FM and 19 FBS patients. The FM patients included in the study had received a diagnosis by

Sample size, sociodemographic characteristics, prevalence, severity, and duration of TMD

The total sample was composed of 51 adult patients (male = 6; female = 45). The FM group was composed of 32 patients (male = 0; female = 32) with a mean age of 52.2 ± 7.8 years. The FM group (P = .002) differed with respect to gender from the FBS group, which was composed of 19 patients (male = 6; female = 13) with a mean age of 50.0 ± 9.1 years. The 2 groups also differed with respect to their education level (P = .03), where a greater number of FM (40.5%) patients had college degrees in

Physical findings

This study investigated the prevalence of symptoms and signs of TMD in FM patients compared with another sample of patients with chronic pain, namely FBS. Fifty-three percent of the FM patients compared with 11% of the FBS patients reported face pain indicating that FM patients were 9.6 times more likely to report face pain than the FBS patients. The greater prevalence of face pain among FM patients compared with FBS patients seems logical as FM represents one end of a spectrum of chronic

Conclusion

The present study replicated and extended previous investigations addressing the relationship between TMD and FM. This study confirmed our hypothesis that the prevalence of TMD is greater among FM patients than among FBS patients. High levels of psychosocial distress and PTSD-like symptoms were found in both the FM and FBS patients, but several measures of psychological distress and dysfunction were significantly higher in FM patients than in FBS patients. We speculated that these results could

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