title: Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain.
abstract: Widespread pain has been found to be a risk factor for onset and persistence of temporomandibular disorder (TMD) pain. The aim of this cohort study was to determine if widespread pain is associated with interference and disability related to TMD pain. Three hundred and ninety-seven TMD patients were interviewed at 1 and 2 years following enrollment. Dysfunctional TMD pain was defined as grades IV, III and II with any disability points on the graded chronic pain scale (GCPS). Widespread pain was defined by the number of pain sites (0-4: head, back, stomach, chest) outside the masticatory system. Multivariable logistic regression analysis, controlling for the effects of age, education, depression, baseline GCPS, and time since study enrollment, was used to examine the relationship between widespread pain and risk of onset or maintenance of dysfunctional TMD pain during follow-up. Among women without dysfunctional TMD pain at baseline, widespread pain was a risk factor for development of dysfunctional TMD pain (odds ratio (OR): 1.9, 95% confidence interval (CI): 1.2-2.8, P=0.003). However, there was no association between widespread pain and onset of dysfunctional TMD pain among men (OR: 1.0, 95% CI: 0.4-2.8, P=0.95) or maintenance of dysfunctional TMD among either women (OR: 1.0, 95% CI: 0.8-1.4, P=0.85) or men (OR: 0.4, 95% CI: 0.1-3.2, P=0.40). Widespread pain was independently and highly associated with risk of developing pain-related disability among women who did not have pain dysfunction at baseline, but was not predictive of risk of onset of dysfunctional TMD pain among men or maintenance of dysfunctional pain among either women or men.
authors.affiliation: Department of Prosthodontics, Martin Luther University, Halle-Wittenberg, Große Steinstr. 19, 06097 Halle/Saale, Germany Department of Biostatistics, University of Washington, Seattle, WA, USA Center for Health Studies, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101-1448, USA Department of Oral Medicine, School of Dentistry, University of Washington, Seattle, WA 98195-6370, USA Department of Epidemiology and Dental Public Health Sciences, University of Washington, 1914 N 34th, Suite 300, Seattle, WA 98103, USA.
authors.forename: Mike Torsten
authors.initials: MT
authors.lastname: John
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
authors.forename: Linda
authors.initials: L
authors.lastname: LeResche
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Cathy W
authors.initials: CW
authors.lastname: Critchlow
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology