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Original Research

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Association Between Clinical Signs of Temporomandibular Disorders and Psychological Distress Among an Adult Finnish Population

  • Lauri Tuuliainen1
  • Kirsi Sipilä1,2,3,4,*,
  • Pirjo Mäki5,6
  • Mauno Könönen7,8
  • Anna Liisa Suominen1,2,9

1Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

2Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland

3Institute of Dentistry, University of Oulu, Oulu, Finland

4Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland

5Department of Psychiatry, Oulu University Hospital, Oulu, Finland

6Institute of Dentistry, University of Helsinki, Helsinki, Finland

7Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland

8National Institute for Health and Welfare (THL), Unit Living Condit Hlth & Wellbeing Helsinki, Helsinki, Finland

DOI: 10.11607/ofph.1439 Vol.29,Issue 4,December 2015 pp.370-377

Published: 30 December 2015

*Corresponding Author(s): Kirsi Sipilä E-mail: kirsi.sipila@uef.fi

Abstract

Aims: To evaluate the association between signs of temporomandibular disorders (TMD) and psychological distress in a general population-based sample of Finnish adults. Methods: The Health 2000 Survey was conducted in 2000–2001 by the National Institute for Health and Welfare in Finland. Of the sample of adults aged 30 or over (n = 8,028), 79% participated in a clinical oral health examination, which included examination of TMD signs. The participants (n = 6,155) also completed questionnaires, including the 12-item General Health Questionnaire (GHQ-12), which measured psychological distress. Associations between TMD signs and psychological distress measured by the GHQ-12 were examined in both genders. Statistical measures included chi-square tests, t tests, and logistic regression analyses. Results: The prevalence of the TMD signs (limited opening, clicking, crepitation, temporomandibular joint [TMJ] palpation pain, and muscle palpation pain) was 11.2%, 17.6%, 10.5%, 5.1%, and 18.9% in women, and 6.1%, 12.9%, 5.3%, 2.4%, and 7.2% in men, respectively. High GHQ-12 scores, measured as continuous variables and in quartiles by distress level, were significantly associated with masticatory muscle pain on palpation in both genders (P < .05) and with TMJ pain on palpation in women (P < .05). Additionally, high GHQ-12 scores as continuous were associated with TMJ crepitation in men (P < .05). The logistic regression analyses showed that higher GHQ-12 scores were associated significantly with masticatory muscle pain on palpation both in women (odds ratio [OR] = 2.18; 95% confidence interval [CI] = 1.6–2.9) and men (OR = 2.03; 95% CI = 1.3–3.1). Conclusion: TMD signs and psychological distress appear to be associated. However, due to the limitations of the study, the findings can be regarded as preliminary.

Keywords

GHQ; Health 2000 Survey; psychological distress; temporomandibular disorders; TMD

Cite and Share

Lauri Tuuliainen,Kirsi Sipilä,Pirjo Mäki,Mauno Könönen,Anna Liisa Suominen. Association Between Clinical Signs of Temporomandibular Disorders and Psychological Distress Among an Adult Finnish Population. Journal of Oral & Facial Pain and Headache. 2015. 29(4);370-377.

References

1. Okeson JP. Management of Temporomandibular Disorders and Occlusion, ed 7. St Louis: Mosby, 2013.

2. Rutkiewicz T, Könönen M, Suominen-Taipale L, Nordblad A, Alanen P. Occurrence of clinical signs of temporomandibular disorders in adult Finns. J Orofac Pain 2006;20:208–217.

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

4. Miettinen O, Lahti S, Sipilä K. Psychosocial aspects of tem-poromandibular disorders and oral health-related quality- of-life. Acta Odontol Scand 2012;70:331–336.

5. Pelkonen ES, Mäki PH, Kyllönen MA, Miettunen JA, Taanila AM, Sipilä KK. Pain-related symptoms of temporomandibular disorders in the offspring of antenatally depressed mothers and depressed parents: A 31-year follow-up of the Northern Finland Birth Cohort 1966. Eur J Pain 2013;17:1048–1057.

6. Sipilä K, Ylöstalo PV, Joukamaa M, Knuuttila ML. Comorbidity between facial pain, widespread pain, and depressive symptoms in young adults. J Orofac Pain 2006;20:24–30.

7. Suvinen TI, Hanes KR, Reade PC. Outcome of therapy in the conservative management of temporomandibular pain dysfunction disorder. J Oral Rehabil 1997;24:718–724.

8. Ridner SH. Psychological distress: Concept analysis. J Adv Nurs 2004;45:536–545.

9. Goldberg D. The Detection of Psychiatric Illness by Questionnaire. Oxford: Oxford University, 1972.

10. Aalto AM, Elovainio M, Kivimäki M, Uutela A, Pirkola S. The Beck Depression Inventory and General Health Questionnaire as measures of depression in the general population: A validation study using the Composite International Diagnostic Interview as the gold standard. Psychiatry Res 2012;197:163–71.

11. Tjakkes G, Reinders J, Tenvergert E, 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.

12. Miyachi H, Wake H, Tamaki K, et al. Detecting mental disorders in dental patients with occlusion-related problems. Psychiatry Clin Neurosci 2007;61:313–319.

13. Wan KY. Orofacial pain symptoms and associated disability and psychosocial impact in community-dwelling and institutionalized elderly in Hong Kong. Community Dent Health 2012;29:110–116.

14. Resende CM, Alves AC, Coelho LT, Alchieri JC, Roncalli AG, Barbosa GA. Quality of life and general health in patients with temporomandibular disorders. Braz Oral Res 2013;27:116–121.

15. Aromaa A, Koskinen S (eds). Health and Functional Capacity in Finland: Baseline Results of the Health 2000 Health Examination Survey. Helsinki: Hakapaino Oy, 2004.

16. Suominen-Taipale L, Nordlad A, Vehkalahti M, Aromaa A. Oral Health in the Finnish Adult Population. Health 2000 Survey. Publications of the National Public Health Institute, B25/2008. Helsinki: Hakapaino Oy, 2008.

17. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6: 301–355.

18. Gureje O, Obikoya B. The GHQ-12 as a screening tool in a primary care setting. Soc Psychiatry Psychiatr Epidemiol 1990; 25:276–280.

19. Gouveia VV, Barbosa GA, Oliveira Andrade Ed, Carneiro MB. Factorial validity and reliability of the general health question-naire (GHQ-12) in the Brazilian physician population. Cad Saude Publica 2010;26:1439–1445.

20. Rudy TE, Turk DC, Kubinski JA, Zaki HS. Differential treatment responses of TMD patients as a function of psychological characteristics. Pain 1995;61:103–112.

21. Sipilä K, Veijola J, Jokelainen J, et al. Association of symptoms of TMD and orofacial pain with alexithymia: An epidemiological study of the Northern Finland 1966 Birth Cohort. Cranio 2001;19:246–251.

22. Sipilä K, Veijola J, Jokelainen J, et al. Association between symptoms of temporomandibular disorders and depression: An epidemiological study of the Northern Finland 1966 Birth Cohort. Cranio 2001;19:183–187.

23. Sipilä K, Mäki P, Laajala A, Taanila A, Joukamaa M, Veijola J. Association of depressiveness with chronic facial pain: A longitudinal study. Acta Odontol Scand 2012;71:644–649.

24. Manfredini D, Lobbezoo F. Relationship between bruxism and temporomandibular disorders: A systematic review of literature from 1998 to 2008. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e26–e50.

25. Chen J, Sobue T, Utreja A, et al. Sex differences in chondrocyte maturation in the mandibular condyle from a decreased occlusal loading model. Calcif Tissue Int 2011;89:123–129.

26. Wells N, Ridner SH. Examining pain-related distress in relation to pain intensity and psychological distress. Res Nurs Health 2008;31:52–62.

27. Elman I, Zubieta J, Borsook D. The missing p in psychiatric training: Why it is important to teach pain to psychiatrists. ArchGen Psychiatry 2011;68:12–20.

28. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6–27.

29. Rusanen J, Silvola AS, Tolvanen M, Pirttiniemi P, Lahti S, Sipilä K. Pathways between temporomandibular disorders, occlu-sal characteristics, facial pain, and oral health-related quality of life among patients with severe malocclusion. Eur J Orthod 2012;34:512–517.

30. Korszun A. Facial pain, depression and stress - connections and directions. J Oral Pathol Med 2002;31:615–619.

31. Charmandari E, Kino T, Souvatzoglou E, Chrousos GP. Pediatric stress: Hormonal mediators and human development. Horm Res 2003;59:161–179.

32. Eriksson M, Lindström B. Antonovsky’s sense of coherence scale and the relation with health: A systematic review. J Epidemiol Community Health 2006;60:376–381.

33. Sipilä K, Ylöstalo P, Könönen M, Uutela A, Knuuttila M. Association of sense of coherence and clinical signs of tem-poromandibular disorders. J Orofac Pain 2009;23:147–152.

34. Antonovsky A. Complexity, conflict, chaos, coherence, coercion and civility. Soc Sci Med 1993;37:969–974.

35. Nilsson KW, Leppert J, Simonsson B, Starrin B. Sense of coherence and psychological well-being: Improvement with age. J Epidemiol Community Health 2010;64:347–352.

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