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Original Research

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Painful Temporomandibular Disorders Are Common in Patients with Postural Orthostatic Tachycardia Syndrome and Impact Significantly upon Quality of Life

  • Justin Durham1,2,3*,
  • Claire McDonald4,5
  • Luke Hutchinson6
  • Julia L. Newton5,7,8

1Oral Surgery and Orofacial Pain, Newcastle University, Newcastle-upon-Tyne, Tyne & Wear, England

2Centre for Oral Health Research, Newcastle Hospitals NHS Foundation Trust, Newcastle University, Tyne & Wear, England

3Institute of Health and Society, Newcastle Hospitals NHS Foundation Trust, Newcastle University, Tyne & Wear, England

4Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

5UK NIHR Biomedical Research Centre in Ageing, Newcastle University, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

6Centre for Oral Health Research, Newcastle University, Newcastle-upon-Tyne, United Kingdom

7Dean of Clincal Medicine, Newcastle-upon-Tyne, Newcastle University, Tyne & Wear, England

8 Newcastle-upon-Tyne, Institute for Ageing and Health, Ageing and Medicine, Newcastle Hospitals NHS Foundation Trust, Newcastle University, Tyne & Wear, England

DOI: 10.11607/ofph.1396 Vol.29,Issue 2,June 2015 pp.152-157

Published: 30 June 2015

*Corresponding Author(s): Justin Durham E-mail: Justin.durham@ncl.ac.uk

Abstract

Aims: To explore the point prevalence of painful temporomandibular disorders (TMD) in a well-characterized clinical cohort of postural orthostatic tachycardia syndrome (PoTS) sufferers and to understand the functional and physiologic impact of this comorbidity on the patient. Methods: Patients with PoTS were retrospectively recruited from a previous study conducted in a UK hospital setting. Data had previously been collected on several parameters, including sociodemographic, physiologic, and functional. The participants were mailed a highly sensitive (99%) and specific (97%) self-report screening instrument for painful TMD. Simple descriptive statistics with Fisher Exact and Kruskal-Wallis tests were used to examine the data and draw inferences from it. Results: A total of 36 individuals responded (69% response rate). Just under half (47%) of the sample screened positive for painful TMD. There was no significant difference between the screening result for TMD or previously reported headaches or joint pain (P > .05). Chronic fatigue syndrome (CFS) was diagnosed by the Fukuda Criteria in 44% of the total sample and in 56% of those with painful TMD. There were no significant differences in physiologic parameters in CFS and TMD. TMD caused a significant decrease in quality of life as measured by the Patient-Reported Outcomes Measurement Information System, Health Assessment Questionnaire (P < .05). Conclusion: TMD are common in patients with PoTS. They have a significant, additional impact on patients’ quality of life and should therefore be screened for at an early stage in PoTS.

Keywords

postural orthostatic tachycardia syndrome; quality of life; temporomandibular disorders

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Justin Durham,Claire McDonald,Luke Hutchinson,Julia L. Newton. Painful Temporomandibular Disorders Are Common in Patients with Postural Orthostatic Tachycardia Syndrome and Impact Significantly upon Quality of Life. Journal of Oral & Facial Pain and Headache. 2015. 29(2);152-157.

References

1. Mathias CJ, Low DA, Iodice V, Owens AP, Kirbis M, Grahame R. Postural tachycardia syndrome--current experience and concepts. Nat Rev Neurol 2012;8:22–34.

2. Goldstein DS, Robertson D, Esler M, Straus SE, Eisenhofer G. Dysautonomias: Clinical disorders of the autonomic nervous system. Ann Intern Med 2002;137:753–763.

3. Grubb BP. Postural tachycardia syndrome. Circulation 2008; 117:2814–2817.

4. McDonald C, Koshi S, Busner L, Kavi L, Newton JL. Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: A UK perspective. BMJ Open 2014;4:e004127.

5. De Leeuw R. Orofacial pain: Guidelines for assessment, diagnosis, and management. Chicago: Quintessence, 2008.

6. Benrud-Larson LM, Dewar MS, Sandroni P, Rummans TA, Haythornthwaite JA, Low PA. Quality of life in patients with postural tachycardia syndrome. Mayo Clin Proc 2002;77:531–537.

7. John MT, Reissmann DR, Schierz O, Wassell RW. Oral health-related quality of life in patients with temporomandibular disorders. J Orofac Pain 2007;21:46–54.

8. Reissmann DR, John MT, Schierz O, Wassell RW. Functional and psychosocial impact related to specific temporomandibular disorder diagnoses. J Dent 2007;35:643–650.

9. Benrud-Larson LM, Sandroni P, Haythornthwaite JA, Rummans TA, Low PA. Correlates of functional disability in patients with postural tachycardia syndrome: Preliminary cross-sectional findings. Health Psychol 2003;22:643–648.

10. Suvinen TI, Reade PC, Kemppainen P, Kononen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: Towards a biopsychosocial model for integra-tion of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain 2005;9:613–633.

11. Maixner W, Greenspan JD, Dubner R, et al. Potential autonomic risk factors for chronic TMD: Descriptive data and empirically identified domains from the OPPERA case-control study. J Pain 2011;12:T75–T91.

12. Nackley AG, Tan KS, Fecho K, Flood P, Diatchenko L, Maixner W. Catechol-O-methyltransferase inhibition increases pain sensitivity through activation of both beta2- and beta3-adrenergic receptors. Pain 2007;128:199–208.

13. Jacob G, Costa F, Shannon JR, et al. The neuropathic postural tachycardia syndrome. N Engl J Med 2000;343:1008–1014.

14. Lewis I, Pairman J, Spickett G, Newton JL. Clinical characteristics of a novel subgroup of chronic fatigue syndrome patientswith postural orthostatic tachycardia syndrome. J Intern Med 2013; 273:501–510.

15. Chen H, Nackley A, Miller V, Diatchenko L, Maixner W. Multi-system dysregulation in painful temporomandibular disorders. J Pain 2013;14:983–996.

16. Mathias CJ, Low DA, Iodice V, Owens AP, Kirbis M, Grahame R. Postural tachycardia syndrome--current experience and concepts. Nat Rev Neurol 2012;8:22–34.

17. Gonzalez YM, Schiffman E, Gordon SM, et al. Development of a brief and effective temporomandibular disorder pain screening questionnaire: Reliability and validity. J Am Dent Assoc 2011; 142:1183–1191.

18. Grubb BP, Row P, Calkins H. Postural tachycardia, orthostatic intolerance and the chronic fatigue syndrome. In: Grubb BP, Olshansky B (eds). Syncope: Mechanisms and Management. Malden, MA: Blackwell/Future Press, 2005:225–244.

19. Light KC, Bragdon EE, Grewen KM, Brownley KA, Girdler SS, Maixner W. Adrenergic dysregulation and pain with and without acute beta-blockade in women with fibromyalgia and temporomandibular disorder. J Pain 2009;10:542–552.

20. Rizzatti-Barbosa CM, Nogueira MT, de Andrade ED, Ambrosano GM, de Barbosa JR. Clinical evaluation of amitriptyline for the control of chronic pain caused by temporoman-dibular joint disorders. Cranio 2003;21:221–225.

21. Sharav Y, Singer E, Schmidt E, Dionne RA, Dubner R. The analgesic effect of amitriptyline on chronic facial pain. Pain 1987; 31:199–209.

22. Kimos P, Biggs C, Mah J, et al. Analgesic action of gabapentin on chronic pain in the masticatory muscles: A randomized controlled trial. Pain 2007;127:151–160.

23. Reissmann DR, John MT, Schierz O, Wassell RW. Functional and psychosocial impact related to specific temporomandibular disorder diagnoses. J Dent 2007;35:643–650.

24. Moufti MA, Wassell RW, Meechan JG, Allen PF, John MT, Steele JG. The Oral Health Impact Profile: Ranking of items for tem-poromandibular disorders. Eur J Oral Sci 2011;119:169–174.

25. Giannakopoulos NN, Keller L, Rammelsberg P, Kronmuller KT, Schmitter M. Anxiety and depression in patients with chronic temporomandibular pain and in controls. J Dent 2010;38: 369–376.

26. Tjakkes GH, Reinders JJ, Tenvergert EM, Stegenga B. TMD pain: The effect on health related quality of life and the influence of pain duration. Health Qual Life Outcomes 2010;8:46.

27. Jerjes W, Upile T, Shah P, Abbas S, Vincent A, Hopper C. TMJ arthroscopy in patients with Ehlers Danlos syndrome: Case series. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110:e12–e20.

28. Wright EF. Manual of Temporomandibular Disorders. Oxford, UK: Wiley, 2009.

29. Fernandez-de-Las-Penas C, Galan-Del-Rio F, Alonso-Blanco C, Jimenez-Garcia R, Arendt-Nielsen L, Svensson P. Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disorders. J Pain 2010;11:1295–1304.

30. Lorduy KM, Liegey-Dougall A, Haggard R, Sanders CN, Gatchel RJ. The prevalence of comorbid symptoms of central sensitization syndrome among three different groups of temporomandib-ular disorder patients. Pain Pract 2013;13:604–613.

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