Widespread pain and the effectiveness of oral splints in myofascial face pain.
BACKGROUND
The research literature reaches inconsistent conclusions about the efficacy of oral splints for treating myofascial face pain. This investigation hypothesizes that their effectiveness varies as a function of the presence or absence of widespread pain.


METHODS
In a randomized, controlled clinical trial, 63 women with myofascial face pain were assigned to use of either an active, maxillary, flat-plane, hard acrylic splint or a palatal splint that did not interfere with occlusion. Participants also were classified according to the presence or absence of widespread pain throughout the body. After six weeks, groups were compared regarding pain on palpation, self-reported pain and functional outcome.


RESULTS
Overall, the findings showed a modest tendency for subjects receiving the active vs. the palatal splint to exhibit improvement on self-reported pain and functional outcome. On further division of the sample into subjects with local vs. widespread pain, the general pattern showed that patients with widespread pain who received an active splint did not experience improvement, while patients with local pain who received the active splint did.


CONCLUSIONS
The presence or absence of widespread pain may help to define the specific circumstances under which oral splints should be prescribed for patients with myofascial face pain.


CONCLUSIONS
Clinicians should screen patients with myofascial face pain for the presence of widespread pain, since this comorbid symptom pattern may be a contraindication for the use of oral splints.
Raphael
K G
KG
University of Medicine and Dentistry of New Jersey, New Jersey Medical School, New Jersey Dental School, 30 Bergen St., ADMC 14, Newark, N.J. 07107, USA. raphaekg@umdnj.edu
Marbach
J J
JJ
D000328:Adult; D000339:Affect / Q000502:physiology; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D000075202:Contraindications; D003679:Deglutition / Q000502:physiology; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology* / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008409:Mastication / Q000502:physiology; D017090:Occlusal Splints; D016017:Odds Ratio; D010147:Pain Measurement; D010173:Palpation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012904:Smiling / Q000502:physiology; D013060:Speech / Q000502:physiology; D013315:Stress, Psychological / Q000523:psychology; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome