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Del Carmen Villaverde-Rodríguez M, Correa-Rodríguez M, Casas-Barragán A, Tapia-Haro RM, Aguilar-Ferrándiz ME. Orofacial Pain and Risk of Dysphagia in Women With Fibromyalgia: A Cross-Sectional Observational Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:883-892. [PMID: 38118459 DOI: 10.1044/2023_ajslp-23-00193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE This study aims to analyze the frequency of dysphagia risk and swallowing-associated quality of life (QoL) in a sample of women with fibromyalgia syndrome (FMS) and examine the potential relationship between risk of dysphagia and chronic orofacial pain (COP) in a sample of women with FMS. METHOD A cross-sectional observational study was conducted in 46 women with FMS. COP was assessed by mouth opening, the orofacial visual analog scale (VAS), and the craniofacial pain and disability inventory (CF-PDI). Risk of dysphagia was assessed using the Eating Assessment Tool (EAT-10) and the volume-viscosity swallowing test (V-VST). Swallowing-associated QoL was determined using the Swallowing Quality of Life (SWAL-QOL) questionnaire. RESULTS Thirty patients were identified as being at risk for dysphagia (65.21%) using the EAT-10 and, according to the SWAL-QOL, 41.30% of patients had alterations in QoL associated with swallowing. The EAT-10 correlated positively with orofacial VAS, CF-PDI-total, CF-PDI-pain and disability, and CF-PDI-jaw-functional status. In relation to SWAL-QOL, negative correlations were observed for orofacial VAS, CF-PDI-total, CF-PDI-pain and disability, and CF-PDI-jaw-functional status. Patients at risk of dysphagia (EAT-10 and V-VST) had significantly higher scores in orofacial VAS (p = .002 and p = .015), CF-PDI-total (p = .006 and p = .014), and CF-PDI-pain and disability (p = .004 and p = .013). CONCLUSIONS In this sample of women with FMS, we identified a high rate of dysphagia risk. Also, a high percentage of these women presented alterations in QoL associated with swallowing. Patients at risk for dysphagia had significantly higher orofacial VAS and CF-PDI-total scores, supporting the relationship between dysphagia risk and COP in FMS. Further research to establish the need for appropriate assessment referrals in clinical practice to determine whether dysphagia is present in this population is needed.
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Affiliation(s)
- María Del Carmen Villaverde-Rodríguez
- PhD Biomedicine Program, Faculty of Health Sciences (Granada), University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Nursing, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - Antonio Casas-Barragán
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - Rosa María Tapia-Haro
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - María Encarnación Aguilar-Ferrándiz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
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Yakkaphan P, Smith JG, Chana P, Tan HL, Ravindranath PT, Lambru G, Renton T. Temporomandibular Disorders and Fibromyalgia Prevalence: A Systematic Review and Meta-Analysis. J Oral Facial Pain Headache 2023; 37:177-193. [PMID: 37975782 PMCID: PMC10664703 DOI: 10.11607/ofph.3260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/25/2022] [Indexed: 11/19/2023]
Abstract
PURPOSE To evaluate the prevalence of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS) in TMD patients and the prevalence of TMDs in patients with FMS. METHOD A systematic search was performed in electronic databases. Studies published in English examining the prevalence of comorbid TMDs and CWP/FMS were included. The Newcastle-Ottawa Scale was used to assess study quality, and meta-analyses using defined diagnostic criteria were conducted to generate pooled prevalence estimates. RESULTS Nineteen studies of moderate to high quality met the selection criteria. Meta-analyses yielded a pooled prevalence rate (95% CI) for TMDs in FMS patients of 76.8% (69.5% to 83.3%). Myogenous TMDs were more prevalent in FMS patients (63.1%, 47.7% to 77.3%) than disc displacement disorders (24.2%, 19.4% to 39.5%), while a little over 40% of FMS patients had comorbid inflammatory degenerative TMDs (41.8%, 21.9% to 63.2%). Almost a third of individuals (32.7%, 4.5% to 71.0%) with TMDs had comorbid FMS, while estimates of comorbid CWP across studies ranged from 30% to 76%. CONCLUSIONS Despite variable prevalence rates among the included studies, the present review suggests that TMDs and CWP/FMS frequently coexist, especially for individuals with painful myogenous TMDs. The clinical, pathophysiologic, and therapeutic aspects of this association are important for tailoring appropriate treatment strategies.
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Bordoni B, Escher AR, Cannadoro G, Tobbi F. The Cognitive and Emotional Aspect in Fibromyalgia: The Importance of the Orofacial Sphere. Cureus 2023; 15:e36380. [PMID: 36945233 PMCID: PMC10025772 DOI: 10.7759/cureus.36380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/22/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a systemic and multifactorial disease of unknown etiology. There are many co-morbidities that the patient presents, making the clinical picture not immediate. Cognitive decline and emotional alteration (anxiety and depression) are found in fibromyalgic patients, as well as temporomandibular joint arthrokinematic disorders, dental malocclusion, and periodontitis. There seems to be a biunivocal relationship between oral and psychiatric dysfunctions in fibromyalgia. The article reviews the information regarding oral health alterations with respect to the patient's cognitive and emotional response, as the most recent information we have raises new hypotheses about the diagnosis of FMS.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
| | - Allan R Escher
- Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | | | - Filippo Tobbi
- Osteopathy, Poliambulatorio Medico e Odontoiatrico, Varese, ITA
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Sahbaz T, Karacay BC. Investigation of temporomandibular disorders in patients with fibromyalgia syndrome: A case-control study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101296. [PMID: 36152974 DOI: 10.1016/j.jormas.2022.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The aim of this study is to compare the frequency of temporomandibular disorders and to examine the temporomandibular pain and functionality levels between healthy female participants and female patients diagnosed with fibromyalgia. MATERIALS AND METHODS Our study included 300 participants. Patients were evaluated according to the Diagnostic Criteria for Temporomandibular Disorders: Assessment Instruments (DC/TMD). While evaluating the patients using DC/TMD, TMD Pain Screener and Symptom questionnaire were used within the scope of Axis I, and Graded Chronic Pain Scale, Jaw Functional Limitation Scale-8 (JFLS-8), Patient Health Questionnaire (PHQ-4) and Oral Behaviors Checklist were applied. RESULTS Bruxism, tooth grinding and masseter hypertrophy were found to be significantly higher in fibromyalgia patients compared to healthy volunteers (p<0.001). The pain screener, JFLS-8, PHQ-4 and OBC scores and GCPS levels were found to be increased in the fibromyalgia group compared to healthy individuals (p<0.001). Considering the post-examination diagnoses of the participants, the diagnoses of myalgia (p=0.022) and disc displacement with reduction (p<0.001) were significantly higher than healthy individuals. CONCLUSIONS Fibromyalgia is a common pathology, therefore, TMD symptoms, which are more difficult to diagnose and often missed, should be questioned in fibromyalgia patients and should be kept in mind in the management of fibromyalgia patients.
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Affiliation(s)
- Tugba Sahbaz
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Kanuni Sultan Suleyman Research Hospital, Istanbul, Turkey.
| | - Basak Cigdem Karacay
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
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Małgorzata P, Małgorzata KM, Karolina C, Gala A. Diagnostic of Temporomandibular Disorders and Other Facial Pain Conditions-Narrative Review and Personal Experience. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E472. [PMID: 32942581 PMCID: PMC7558197 DOI: 10.3390/medicina56090472] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/02/2022]
Abstract
Temporomandibular disorders are complex dysfunctions of masticatory muscles and temporomandibular joints. Their symptoms affect more than 40% of the population and their prevalence is rising. It is important to establish a unified protocol for this specialistic examination. This review describes the authors' own longstanding experiences and the discrepancies in the current literature regarding this topic as well as a detailed procedure of diagnosing temporomandibular disorders including the leading but often underrated role of a medical interview. We presented optimal physical examination methods as well as specific situations in which additional diagnostic and imaging tools may be useful. The emphasis was put on the importance of differential diagnosis between temporomandibular disorders and other diseases presenting with similar symptoms.
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Affiliation(s)
- Pihut Małgorzata
- Prosthodontic Department, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, 4 Montelupich Str., 31-155 Krakow, Poland; (P.M.); (A.G.)
| | - Kulesa-Mrowiecka Małgorzata
- Department of Physiotherapy, Institute of Physiotherapy, Faculty of Health Science, Jagiellonian University Medical College, 12 Michalowskiego Str., 31-143 Krakow, Poland;
| | - Chmura Karolina
- Prosthodontic Department, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, 4 Montelupich Str., 31-155 Krakow, Poland; (P.M.); (A.G.)
| | - Andrzej Gala
- Prosthodontic Department, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, 4 Montelupich Str., 31-155 Krakow, Poland; (P.M.); (A.G.)
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Ayouni I, Chebbi R, Hela Z, Dhidah M. Comorbidity between fibromyalgia and temporomandibular disorders: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:33-42. [DOI: 10.1016/j.oooo.2019.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/05/2019] [Accepted: 02/23/2019] [Indexed: 01/08/2023]
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Garrigós-Pedrón M, La Touche R, Navarro- Desentre P, Gracia-Naya M, Segura-Ortí E. Widespread mechanical pain hypersensitivity in patients with chronic migraine and temporomandibular disorders: relationship and correlation between psychological and sensorimotor variables. Acta Odontol Scand 2019; 77:224-231. [PMID: 30626243 DOI: 10.1080/00016357.2018.1538533] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to assess mechanical hyperalgesia in the trigeminal and extra-trigeminal regions in patients with chronic migraine (CM) and temporomandibular disorders (TMD) in comparison to asymptomatic subjects and to determine the association between sensorimotor variables and psychological and disability variables and evaluate the prediction of a sensorimotor variables though psychological and disability variables in patients with CM and TMD. MATERIAL AND METHODS A total of 52 subjects with concomitant CM and TMD and 30 asymptomatic subjects were included in the study. The pressure pain threshold (PPT), maximal mouth opening (MMO) and a series of self-reported factors were compared. RESULTS There were 52 CM and TMD (92.3% women and 7.7% men; age = 46.2 ± 9.5) and 30 asymptomatic subjects (80% women and 20% men; age = 47.4 ± 10). Differences were found between patients with CM and TMD and asymptomatic participants (p < .01) when comparing the PPTs in the trigeminal and extra-trigeminal regions. The PPT for the trigeminal region was predicted by depressive symptoms (variance of 18%) as well as disability and craniofacial pain (variance of 20%). The extra-trigeminal region PPT was predicted by depressive symptoms (variance of 10%), and pain-free MMO was predicted by disability and craniofacial pain (variance of 24%). CONCLUSIONS This study suggests that patients with CM and TMD present with generalized mechanical hyperalgesia. In addition, an association between sensorimotor, psychological and disability variables was observed.
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Affiliation(s)
- Miriam Garrigós-Pedrón
- Departamento de Fisioterapia, Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | - Manuel Gracia-Naya
- Doctor in Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Evaluation of C-Reactive Protein Level in Patients with Pain Form of Temporomandibular Joint Dysfunction. Pain Res Manag 2018; 2018:7958034. [PMID: 29849849 PMCID: PMC5911313 DOI: 10.1155/2018/7958034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/11/2017] [Accepted: 03/12/2018] [Indexed: 02/01/2023]
Abstract
Temporomandibular joint dysfunction is a functional disorder concerned with the abnormal functioning of the muscles of the stomatognathic system and temporomandibular joints involved in the dynamic movements of the jaw and surrounding structures. The aim of the study was to compare the level of C-reactive protein in patients with pain and painless forms of temporomandibular joint dysfunction. Materials and methods. The study group consisted of 72 patients who reported to the prosthetic treatment because of temporomandibular joint dysfunction. The study group included 36 patients with pain form of dysfunction, and the control group included 36 patients with painless form of disorder. Each patient underwent specialized examination of functional disorders in order to diagnose the type of dysfunction and was commissioned to carry out a study of the blood test concerned with evaluation of the C-reactive protein (CRP) level in the same analytical laboratory. The results of the investigation were subjected to statistical analysis. The research obtained approval from the Ethics Committee of the Jagiellonian University (KBET/125/L/2013). Level of Evidence for primary research was established as type V. Results. The mean values of C-reactive protein levels in both groups were in the normal range and did not differ statistically significantly, which indicates the fact that the pain form of the temporomandibular joint disorders is not associated with inflammation of the soft tissues of the joint. Conclusion. Painful form of the temporomandibular joint dysfunctions is not connected with the inflammation of joints.
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Wieckiewicz M, Zietek M, Smardz J, Zenczak-Wieckiewicz D, Grychowska N. Mental Status as a Common Factor for Masticatory Muscle Pain: A Systematic Review. Front Psychol 2017; 8:646. [PMID: 28536539 PMCID: PMC5422479 DOI: 10.3389/fpsyg.2017.00646] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/11/2017] [Indexed: 02/02/2023] Open
Abstract
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.
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Affiliation(s)
- Mieszko Wieckiewicz
- Department of Prosthetic Dentistry, Wroclaw Medical UniversityWroclaw, Poland
| | - Marek Zietek
- Department of Periodontology, Wroclaw Medical UniversityWroclaw, Poland
| | - Joanna Smardz
- Department of Prosthetic Dentistry, Wroclaw Medical UniversityWroclaw, Poland
| | | | - Natalia Grychowska
- Department of Prosthetic Dentistry, Wroclaw Medical UniversityWroclaw, Poland
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