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Associations between craniomandibular disorders, sociodemographic factors and self-perceived general and oral health in an adult population
Umeå University, Faculty of Medicine, Department of Odontology.
Umeå University, Faculty of Medicine, Department of Odontology.
2014 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 8, p. 1054-1065Article in journal (Refereed) Published
Abstract [en]

Objective. The aim of this study was to analyze the relationships between pain in the craniomandibular region and jaw dysfunction, respectively, to sociodemographic factors and self-perceived general and oral health in a middle-aged and elderly population in Västerbotten County, Sweden.

Materials and methods. Six hundred individuals, 35-, 50-, 65- and 75 years old, from inland and 600 individuals from coastal areas were randomly selected in 2002. Of these, 987 individuals completed a questionnaire and 779 participated in a clinical examination. Thirty-five- and 50-year-olds together constituted a middle-aged group and the rest an elderly group.

Results. Among the middle-aged, craniomandibular pain was associated with impaired general health status, signs of temporomandibular disorder (TMD) pain were associated with female gender and living alone, jaw dysfunction symptoms were associated with university degree and chewing with caution; and signs of TMD dysfunction were associated with female gender and living in the more densely populated coastal region. Among the elderly, craniomandibular pain was more common among those living in the inland region, craniomandibular pain and signs of TMD pain were associated with impaired general health status, jaw dysfunction symptoms were associated with higher education level and self-perceived impaired general health and oral health; and signs of TMD dysfunction were associated with female gender and living in the coastal region. Dental status was not associated with craniomandibular pain.

Conclusions. Socioeconomic factors and impaired general state of health were related to signs and symptoms indicative of CMD. These factors may influence demand for treatment among the affected.

Place, publisher, year, edition, pages
Informa Healthcare, 2014. Vol. 72, no 8, p. 1054-1065
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-94533DOI: 10.3109/00016357.2014.949843ISI: 000344330400070PubMedID: 25220523Scopus ID: 2-s2.0-84951780871OAI: oai:DiVA.org:umu-94533DiVA, id: diva2:754816
Available from: 2014-10-13 Created: 2014-10-13 Last updated: 2023-03-24Bibliographically approved
In thesis
1. Perspectives on signs and symptoms indicative of temporomandibular disorders among adults
Open this publication in new window or tab >>Perspectives on signs and symptoms indicative of temporomandibular disorders among adults
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The aim of this thesis was to delve deeper into the different aspects of temporomandibular disorders (TMD) as a public health problem among adults. The studies evaluated signs and symptoms indicative of TMD in terms of prevalence, associated factors, treatment need estimate, possible factors underpinning treatment need owing to TMD, as well as possible influences of pain conditions on TMD symptoms and diagnosis in adult populations.

Study populations and Methods: The thesis is comprised of five papers. The first four papers (I-IV) included individuals 35, 50, 65 and, 75 years old living in Västerbotten County, Sweden. The study sample was stratified based on the area of residence – coast (mainly urban area) and inland (mainly rural area). Scrutiny constituted a questionnaire and a clinical examination. Of 1200 individuals contacted (300 in each age group), 987 (82%) returned a filled-out questionnaire and 779 (65%) participated in the clinical examination. Distribution of signs and symptoms indicative of TMD in the different age groups, associations between different factors and TMD signs, symptoms and treatment need owing to TMD, as well as association between different patterns of pain to palpation and pain in the jaw-face-head region were analyzed. Paper V assessed the association between widespread pain and TMD pain in 300 individuals of which 110 diagnosed as TMD pain according to DC/TMD (arthralgia, myalgia and myofascial pain with referral). Logistic regression analysis was applied in the papers II-V and the results were presented as odds ratios (OR) with 95% confidence interval (95% CI).

Results: The prevalence of symptoms indicative of TMD and frequent headaches was high in the adult population. The age and gender patterns were, for the most part, similar for the frequent symptoms in terms of prevalence. In general, lower prevalence of frequent headaches and symptoms indicative of TMD were observed among the elderly compared to the younger age groups. Clinical signs indicative of TMD were more commonly registered among women. In the analysis of putative factors related to presence of signs and symptoms, self- perceived impaired general health status was the most consistent finding in the different age groups. The estimated treatment need owing to TMD was 15% for the total sample. The presence of TMD signs, symptoms, smoking, living on the coast, and being a woman emerged as important factors in the clinical decision- making process of treatment need due to TMD. A significant dose-response like pattern was observed between frequent pain in the jaw-face-head region and the patterns of pain elicited to palpation. Individuals with widespread pain compared to those without widespread pain significantly more often had a TMD diagnosis of myofascial pain with referral and myalgia according to the DC/TMD.

Conclusions: The age and gender differences on signs and symptoms indicative of TMD among adults are likely related to factors included in the biopsychosocial model. The associations between comorbidities and TMD may influence demand for treatment among the affected. Thus, TMD treatment should be included in the medical health care payment systems. A significant proportion of the adult population has a need of treatment related to TMD. Generalized hyperalgesia and widespread pain conditions are related to pain in the jaw-face-head region and should be acknowledged in clinical evaluations, diagnostic decisions, treatment planning as well as in research settings.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2021. p. 80
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 145
Keywords
epidemiology, temporomandibular disorders, headache, gender, treatment need, clinical decision-making, widespread pain
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-183170 (URN)978-91-7855-555-0 (ISBN)978-91-7855-554-3 (ISBN)
Public defence
2021-06-15, Sal B, byggnad 1D, våning 9, Umeå, 09:00 (English)
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Available from: 2021-05-25 Created: 2021-05-18 Last updated: 2021-06-17Bibliographically approved

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Yekkalam, NeginWänman, Anders

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