title: Clinical findings and pain symptoms as potential risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study.
abstract: Clinical characteristics might be associated with temporomandibular disorders (TMD) because they are antecedent risk factors that increase the likelihood of a healthy person developing the condition or because they represent signs or symptoms of either subclinical or overt TMD. In this baseline case-control study of the multisite Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) project, 1,633 controls and 185 cases with chronic, painful TMD completed questionnaires and received clinical examinations. Odds ratios measuring association between each clinical factor and TMD were computed, with adjustment for study-site as well as age, sex, and race/ethnicity. Compared to controls, TMD cases reported more trauma, greater parafunction, more headaches and other pain disorders, more functional limitation in using the jaw, more nonpain symptoms in the facial area, more temporomandibular joint noises and jaw locking, more neural or sensory medical conditions, and worse overall medical status. They also exhibited on examination reduced jaw mobility, more joint noises, and a greater number of painful masticatory, cervical, and body muscles upon palpation. The results indicated that TMD cases differ substantially from controls across almost all variables assessed. Future analyses of follow-up data will determine whether these clinical characteristics predict increased risk for developing first-onset pain-related TMD PERSPECTIVE: Clinical findings from OPPERA's baseline case-control study indicate significant differences between chronic TMD cases and controls with respect to trauma history, parafunction, other pain disorders, health status, and clinical examination data. Future analyses will examine their contribution to TMD onset.
authors.affiliation: Department of Oral Diagnostic Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, USA. ohrbach@buffalo.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Ohrbach
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.forename: Flora
authors.initials: F
authors.lastname: Mulkey
authors.forename: Yoly
authors.initials: Y
authors.lastname: Gonzalez
authors.forename: Sharon
authors.initials: S
authors.lastname: Gordon
authors.forename: Henry
authors.initials: H
authors.lastname: Gremillion
authors.forename: Pei-Feng
authors.initials: PF
authors.lastname: Lim
authors.forename: Margarete
authors.initials: M
authors.lastname: Ribeiro-Dasilva
authors.forename: Joel D
authors.initials: JD
authors.lastname: Greenspan
authors.forename: Charles
authors.initials: C
authors.lastname: Knott
authors.forename: William
authors.initials: W
authors.lastname: Maixner
authors.forename: Gary
authors.initials: G
authors.lastname: Slade
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D059350:Chronic Pain / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity / Q000639:trends; D003753:Dental Health Surveys / Q000592:standards; D005157:Facial Pain / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000379:methods; D018482:Muscle, Skeletal / Q000503:physiopathology; D010808:Physical Examination / Q000379:methods; D044469:Racial Groups; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires / Q000592:standards; D013704:Temporomandibular Joint / Q000293:injuries / Q000503:physiopathology*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
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