TMD chronic pain and masseter silent period in psychiatric patients on antidepressive therapy

The impact of stress, anxiety and depression on stomatognathic system of physiotherapy and dentistry first-year students

INTRODUCTION

It is well proven that psychoemotional factors play causative role in development of many civilization diseases. Psychosocial stress is effecting with development of certain oral parafunctions like teeth grinding, bruxism, or cheeks biting. Eventually, all of those parafunctional activities may cause increase of masticatory muscles tone and provoke its intensification. Literature indicates that students must cope with greater level of stressful situations than the average representative of the society.

METHODS

The research group comprised Ist-year physiotherapy and dentistry students from University School of Physical Education in Wroclaw and Wroclaw Medical University. The study consisted the following: psychological and health questionnaires, and stomatological examination with masseter muscles' electromyography.

RESULTS

In intraoral examination, symptoms of parafunctions were more frequently observed in physiotherapy students. The mean tone of masseters was higher also among physiotherapy students. The level of perceived stress was high in both groups, and the experienced borderline and incorrect results in Hospital Anxiety and Depression Scale were more frequently observed in dentistry students. The mean tone of masseter muscle was rising with the level of anxiety in physiotherapy group. Among dentistry, the tendency for rise of masseter muscle tone together with level of anxiety and depression was observed.

CONCLUSIONS

Physiotherapy and dentistry beginners differ between each other's by prevalence of temporomandibular disorders (TMD) and oral parafunction symptoms. The level of perceived stress is high in both groups. The level of experienced anxiety and depression is higher in dentistry group. In both study groups, there is significant growth and tendency for simultaneous rise of masseter muscle tone accordingly to stress, anxiety, and depression indicators.

Is there a relationship between psychological factors and TMD?

INTRODUCTION

Medical students are in a very demanding environment and are affected by high degree of stress. High levels of anxiety can affect a student's academic performance and also increase the risk of other health-related problems. This study aims to evaluate, thanks to the intensity of stress manifestations (4DSQ) together with the sense of coherence (SOC), the prevalence of TMD and oral parafunctions in students enrolled in the University of Medical Sciences. Moreover, it aims to evaluate the relationship between the psychosocial manifestations of stress and sense of coherence in relation to gender.

MATERIALS AND METHODS

A total of 324 students of Poznań University of Medical Sciences participated in this study. Students were assessed using a three-part questionnaire: one was to assess symptoms of TMD, the second part was 4DSQ, and the third was a SOC Questionnaire.

RESULTS

About one-third of the students in this study presented symptoms of TMD and perceived more intensively symptoms of distress, anxiety, somatization, and depression. They presented a higher level of somatic symptoms and a lower level of Sense of Coherence than students without TMD symptoms.

CONCLUSION

There is a strong negative relationship between the sense of coherence and the level of perceived distress, anxiety, somatization, and depression. Female students attending Medical School showed a higher level of somatization of stress but with a higher capacity to overcome challenges as compared to men.

Mental Status as a Common Factor for Masticatory Muscle Pain: A Systematic Review

Masticatory muscle pain (MMP) is the primary reason for chronic non-odontogenic orofacial pain in the human population. MMP has become a considerable social problem, which affects about 12-14% of the adult population and is 1.5-2 times more frequent in women than in men. This term defines a pain which has its origins in the masticatory muscles. Although MMP is typically felt in the face, jaws, and preauricular area, MMP can radiate to the ear, teeth, head, and neck. This systematic review explains the relationship between MMP and common mental states, such as anxiety, depression, mood and stress-related disorders, and is reported in accordance with PRISMA guidelines. We performed a search in the PubMed database for peer-reviewed articles published after November 1st 2006 in the context of MMP and mental states. According to the defined criteria, 38 studies were finally included into the systematic review, of which prospective cohort studies were found to be the most common. We investigated four primary outcomes (anxiety, depression, mood disorders, and stress-related disorders) and several secondary outcomes of search. Seventy-nine percent of studies concerned depression, 42% anxiety, 29% mood disorders, and 21% stress-related disorders. Most of the studies showed a relationship between MMP and alterations in mental status. Nonetheless, the researchers usually evidenced only the co-occurrence of psychiatric disorders and dysfunctions of the masticatory muscles among the group of patients, in large part in women. Moreover, some studies were marked with limited generalizability of the reported results, quality flaws and heterogeneity. In the light of the analyzed literature, the causal relationship between mental states and MMP is still not clearly established.