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A two-year follow-up study of temporomandibular disorders in a female Sami population: validation of cases and controls as predicted by questionnaire
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
2007 (Engelska)Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, nr 6, s. 341-347Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: The first aim of this study was to validate persistent, severe symptoms of temporomandibular disorders (TMD) among Sami females, as predicted by questionnaire. The second aim was to establish diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis 1 among predicted cases and controls. The third aim was to compare subjects with severe TMD to controls in regard to dental occlusion, general health, and parafunctions.

MATERIAL AND METHODS: The subjects, Sami females living in the Arctic region of northern Sweden, all with long-standing (>or=1 year), intense (>or=5 on NS), and frequent (>or=once a week) symptoms of pain and dysfunction in the jaw-face region, were invited for clinical examination; 22 (63%) agreed to participate. Forty-six subjects with no symptoms in the jaw-face region were matched to these cases in accordance with five age groups. The examiner was blind to subject affiliation.

RESULTS: The positive predictive value of presenting with signs and symptoms of TMD at follow-up was 0.82; the negative value was 0.87. Cases reported impaired general health and awareness of parafunctions significantly more frequently than did controls. Registered dental occlusion factors did not distinguish cases from controls.

CONCLUSIONS: Long-standing, intense, and frequent TMD symptoms remained essentially unchanged over the 2-year follow-up of females in a Sami population. Presence of severe TMD was related to impaired general health and awareness of oral parafunctions.

Ort, förlag, år, upplaga, sidor
Informa Healthcare, 2007. Vol. 65, nr 6, s. 341-347
Nyckelord [en]
Females, pain, prospective, Sami, temporomandibular
Nationell ämneskategori
Odontologi
Identifikatorer
URN: urn:nbn:se:umu:diva-20919DOI: 10.1080/00016350701742356ISI: 000251547900006PubMedID: 18071955Scopus ID: 2-s2.0-37048999555OAI: oai:DiVA.org:umu-20919DiVA, id: diva2:210067
Tillgänglig från: 2009-03-30 Skapad: 2009-03-30 Senast uppdaterad: 2023-03-24Bibliografiskt granskad
Ingår i avhandling
1. Temporomandibular disorders among Sami women: perspectives based on an epidemiological survey with mixed methods
Öppna denna publikation i ny flik eller fönster >>Temporomandibular disorders among Sami women: perspectives based on an epidemiological survey with mixed methods
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Introduction The aim of the research project was to examine prevalence, co-morbidity, and impact on daily life of pain and dysfunction in the jaw-face, head, and neck-shoulder regions among adult Sami women in northern Sweden. The aim of the qualitative part of the study was to explore, thoughts, experiences, and beliefs regarding temporomandibular disorders (TMD) among Sami women with and without TMD, to gain insights into their health care experiences.

Methods The research project used a mixed methods approach including questionnaire analysis, a case-control study, and thematic interviews. The study population (Papers I and III) included 487 women living in the Arctic region of northern Sweden and enrolled in the register of the Swedish Sami Parliament or registered as reindeer owners or reindeer herders in the Swedish Board of Agriculture. Two years after the questionnaire study, 22 women (cases) with longstanding, intense, and frequent symptoms indicative of TMD, together with 46 age-matched women (controls) without any symptoms in the jaw–face region, underwent a clinical examination of the function of the temporomandibular joint, jaw- and neck muscles, mandibular mobility, and dental occlusion. The examiner was blind to the women’s affiliation (Paper II). Thematic interviews with a strategic subsample of 17 Sami women (Paper IV) were thereafter conducted and analyzed with a grounded theory approach.

Results The prevalence of frequent symptoms indicative of TMD was 17%, of headaches 19%, and of neck-shoulder pain (NSP) 30%. Seventeen percent reported that their TMD affected daily life. Duration of jaw pain, troublesome impaired jaw opening, and neck pain, together with a low education level, affected the statement of whether TMD influenced daily life or not. Factors related to pain had the greatest influence when these Sami women rated the related impairment. There was a statistically significant relationship between TMD, frequent headaches, and frequent NSP (P <0.0001). Longstanding, intense, and frequent symptoms indicative of TMD remained essentially unchanged over the two-year follow-up period. Cases reported impaired general health and awareness of clenching teeth significantly more frequently than did controls. Variations in dental occlusion did not distinguish cases from controls. In the qualitative part of the project the core category, “Grin(d) and bear it,” summarizes the participants’ various ways and stages of processing and handling the interacting categories: (1) triggers, (2) strains, (3) distrust, and (4) reconciliation with pain and/or difficulties in life. Perpetuating factors were described as mental-physical strain and stress, and also a tooth clenching behavior. Women without TMD expressed factors that helped them to handle strains, reconcile, and stay healthy. They relied on helpful social support.

Conclusion Disabling TMD, headaches, and NSP are common in Sami women. Women with TMD commonly expressed that tooth clenching was a familiar habit related to strains in life; they described an impaired general state of health and distrust in the care providers’ competence and ability to manage their problems. Women without TMD expressed confidence in their self-efficacy and were generally less concerned with strains in their lives. Rehabilitation strategies aiming at empowerment and improved self-efficacy may be a successful approach in women with disabling TMD.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2014. s. 83
Serie
Umeå University odontological dissertations, ISSN 0345-7532 ; 133
Nyckelord
epidemiology, gender, headache, indigenous, pain, qualitative, quality of life, temporomandibular
Nationell ämneskategori
Odontologi
Forskningsämne
odontologi
Identifikatorer
urn:nbn:se:umu:diva-92696 (URN)978-91-7601-121-8 (ISBN)
Disputation
2014-10-03, Sal B, byggnad 1D, Norrlands universitetssjukhus, Umeå, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2014-09-12 Skapad: 2014-09-01 Senast uppdaterad: 2018-06-07Bibliografiskt granskad

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Storm Mienna, ChristinaWänman, Anders

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