Dentists' ability to detect psychological problems in patients with temporomandibular disorders and chronic pain

Article Abstract:

Temporomandibular disorders (TMD) are characterized by aching pain and clicking sounds in the joint at the back of the jaw, particularly during chewing. One cause of TMD is grinding or clenching the teeth during sleep, which is thought to be a reaction to psychological stress. While psychosocial difficulties may cause TMD, they may also interfere with the success of conventional medical treatment. It is desirable to identify patients with psychological problems, both as a means of selecting the best treatment for their physical disorder and as a way of referring them for the psychological care they need. It has been suggested that dentists may be able to form an accurate psychological impression while interviewing a patient, but no study has been done to assess psychological problems in patients with TMD. One hundred and seven patients with TMD whose primary problem was musculoskeletal pain were given standardized psychological tests and them examined by dentists who did not have access to the test results. The dentists formed their impressions and then filled out a brief questionnaire rating the degree of depression, anxiety, denial, and recent stress in the patient's life. Overall, the dentists' ratings were low in specificity and sensitivity, suggesting that they could not adequately detect psychological problems in this TMD population. Formal psychological testing of TMD patients cannot be endorsed as yet because research has not demonstrated that these psychological factors are consistent predictors of TMD treatment outcome. Other personality traits that should be studied in relation to TMD are hypochondriasis, hysteria, anger and hostility. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Usage, Abnormalities, Patients, Psychological tests

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Physical medicine procedures affect temporomandibular disorders: a review

Article Abstract:

Disorders of the temporomandibular joint (TMJ, the joint of the jaw) can be treated by the procedures of physical medicine, and results of such treatment are reviewed and evaluated. Accurate evaluation of clinical outcomes is hindered by the fact that few controlled studies have been done. Procedures include exercise therapy, application of heat and cold, ultrasound, electrical stimulation, biofeedback, massage, and mobilization. Temporomandibular disorders (TMD) may be divided into three categories: intracapsular disorders (where the problem is within the joint capsule); myogenous (muscle) pain and dysfunction; and mandibular (lower jaw) mobility disorders. Clicking is the TMJ symptom that responds least to treatment. Joint locking, pain, and disease associated with arthritis are discussed. Myalgia (muscle pain), myositis (muscle swelling), trismus (constant muscle contraction), and dyskinesia (immobility) are types of muscle disorders that can affect the TMJ. Mobility can be so abnormal that the jaw dislocates (hypermobility) or adhesions (fibrous tissue) develop, impairing mobility (hypomobility). Possible etiological agents are discussed, when known. TMJ clicking, though often treated by an exercise avoidance approach, does not yet have an effective remedy. The methods of physical medicine appear to be helpful for some symptoms associated with a locked TMJ, but they are most effective in relieving muscle pain associated with TMD. However, symptom relief is not a substitute for treating the cause of the disorder or discomfort. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Medicine, Physical, Physical medicine and rehabilitation

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Occlusal stabilization appliances: evidence of their efficacy

Article Abstract:

Occlusal appliances appear to be effective in treating temporomandibular joint disorder (TMJ), according to researchers who analyzed the scientific evidence. These devices probably work by modifying jaw clenching.

Orthodontic appliances

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