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Researchers relate mood disorders to temporomandibular joint pain

By Dental Tribune International
February 18, 2013

GREIFSWALD, Germany: People with depression and anxiety have an increased risk of temporomandibular pain upon palpation, German researchers have found. Despite the ongoing debate about the role of psychological disorder symptoms as risk factors for temporomandibular joint (TMJ) pain, large-scale studies prior to this study had not been conducted.

Temporomandibular joint dysfunction syndrome (TMD) is an umbrella term for a range of craniofacial problems with a multi-faceted aetiology. Tooth grinding, facial clenching and genetic factors may initiate TMD and bio-behavioural studies have suggested an association between TMJ pain and depression, anxiety and post-traumatic stress disorder.

In the German study, the research team sought to estimate the relative risk of TMJ pain owing to depressive symptoms and anxiety over five years. More than 4,000 subjects participated and underwent medical examination, oral health assessment and a health-check interview, and completed a psychiatric risk factor questionnaire. TMJ pain was assessed in an oral health examination according to guidelines from the American Academy of Orofacial Pain.

The investigators found that depressive symptoms were more strongly associated with joint pain than muscle pain, and that anxiety symptoms were linked to muscle pain. The authors stated that depressive and anxiety symptoms may initiate muscular hyperactivity followed by muscle abnormality and altered muscle mechanics, which can produce inflammation and cause muscle pain. They also suggested that TMD might be related to abnormal pain stimuli processing caused by imbalances in serotonin and catecholamines (neurotransmitters). Thus, TMJ pain might be a physical manifestation of anxiety or depression.

In support of previous published research, the authors concluded there is a strong to moderate relationship between symptoms of depression or anxiety and signs of TMD.

The study, titled “Depressive and anxiety symptoms as risk factors for temporomandibular joint pain: A prospective cohort study in the general population”, was published in the December issue of the Journal of Pain.

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