Being a woman influences the development of temporomandibular disorder: cross-sectional study
Ser mulher influencia no desenvolvimento de disfunção temporomandibular: estudo transversal
Laura Betina Lopes Pinheiro; Lucas Machado Maracci; Fernanda Tomazoni; Gabriela Salatino Liedke; Tatiana Bernardon Silva; Mariana Marquezan
Abstract
BACKGROUND AND OBJECTIVES: Although women seem to be more susceptible to pain, there are few studies comparing the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses between women and men. Thus, this study aimed to verify the influence of gender on Temporomandibular Disorders (TMD) and their comorbidities in a Brazilian sample.
METHODS: Patients were assessed using the RDC/TMD. Diagnoses were obtained for Axis I (myofascial pain, disc displacement, and other joint conditions) and Axis II (depressive symptoms, chronic pain, somatization, and limitation of mandibular function). Logistic regression models were used to verify whether there is a difference in the prevalence and odds of developing TMD between women and men.
RESULTS: The sample included 310 patients. Women had more myofascial pain and were more likely to develop it (73.04%; OR: 1.91; IC 95%: 1.08 - 3.39), as well as more joint disorders (54.78%; OR: 2.07; IC 95%: 1.08 - 3.99), in comparison to men. Furthermore, women composed the majority of the sample, more often sought treatment, and had more severe levels of depressive symptoms, somatization of pain, limitation of mandibular function, and myofascial pain.
CONCLUSION: Women have more TMD and are more likely to develop it, and also show more severe levels of depressive symptoms, pain somatization, limited mandibular function, and myofascial pain.
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: Embora as mulheres pareçam ser mais suscetíveis à dor, há poucos estudos comparando os diagnósticos obtidos por meio do Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) entre mulheres e homens. Assim, este estudo teve como objetivo verificar a influência do sexo nas disfunções temporomandibulares (DTM) e suas comorbidades em uma amostra brasileira.
MÉTODOS: Os pacientes foram avaliados por meio do RDC/ TMD. Os diagnósticos foram obtidos para o Eixo I (dor miofascial, deslocamento de disco e outras condições articulares) e Eixo II (sintomas de depressão, dor crônica, somatização e limitação da função mandibular). Modelos de regressão logística foram utilizados para verificar se existe diferença na prevalência e nas chances de desenvolver DTM entre mulheres e homens.
RESULTADOS: A amostra incluiu 310 pacientes. As mulheres apresentaram mais dor miofascial e foram mais propensas a desenvolvê-la (73,04%; OR: 1,91; IC 95%: 1,08 - 3,39), bem como mais distúrbios articulares (54,78%; OR: 2,07; IC 95%: 1,08 - 3,99), em comparação aos homens. Ademais, as mulheres compuseram a maioria da amostra, procuraram tratamento com maior frequência e apresentaram níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial.
CONCLUSÃO: As mulheres apresentam mais DTM e são mais propensas a desenvolvê-la, bem como apresentam níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial.
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References
1 Menezes AB, Brito RCS, Henriques AL. Relation between gender and sexual orientation from the evolutionary approach. Psic Teor Pesq. 2010;26(2):245-52.
2 Aggarwal VR, Lovell K, Peters S, Javidi H, Joughin A, Goldthorpe J. Psychosocial interventions for the management of chronic orofacial pain. Cochrane Database Syst Rev. 2011;(11):CD008456.
3 List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017;37:692-704.
4 Leeuw R, Klasser GD. Orofacial pain : guidelines for assessment, diagnosis, and management. 6th edition. Chicago: Quintessence Publishing Co, 2018.
5 Halpern LR, Levine M, Dodson TB. Sexual dimorphism and temporomandibular disorders (TMD). Oral Maxillofac Surg Clin North Am. 2007;19(2):267-77.
6 Shaefer JR, Holland N, Whelan JS, Velly AM. Pain and temporomandibular disorders: a pharmaco-gender dilemma. Dent Clin North Am. 2013;57(2):233-62.
7 Goulet JP, Lavigne GJ, Lund JP. Jaw pain prevalence among French-speaking Canadians in Québec and related symptoms of temporomandibular disorders. J Dent Res. 1995;74(11):1738-44.
8 Yadav S, Yang Y, Dutra EH, Robinson JL, Wadhwa S. Temporomandibular joint disorders in older adults. J Am Geriatr Soc. 2018;66(6):1213-7.
9 Aufdemorte TB, Van Sickels JE, Dolwick MF, Sheridan PJ, Holt GR, Aragon SB, Gates GA. Estrogen receptors in the temporomandibular joint of the baboon (Papio cynocephalus): an autoradiographic study. Oral Surg Oral Med Oral Pathol. 1986;61(4):307-14.
10 Flake NM, Bonebreak DB, Gold MS. Estrogen and inflammation increase the excitability of rat temporomandibular joint afferent neurons. J Neurophysiol. 2005;93(3):1585-97.
11 Sarlani E, Farooq N, Greenspan JD. Gender and laterality differences in thermosensation throughout the perceptible range. Pain. 2003;106(1-2):9-18.
12 Herreira-Ferreira M, Costa YM, Cunha CO, Conti AC, Conti PC, Bonjardim LR. Experimental pain thresholds and psychosocial features across menstrual cycle in myofascial orofacial pain compared to healthy individuals: cross-sectional study. BrJP. 2023;6(2):107-12.
13 Manfredini D, Winocur E, Ahlberg J, Guarda-Nardini L, Lobbezoo F. Psychosocial impairment in temporomandibular disorders patients. RDC/TMD axis II findings from a multicentre study. J Dent. 2010;38(10):765-72.
14 Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-55.
15 Mendes LM, Barreto MC, Castro SS. Instruments that assess functioning in individuals with temporomandibular disorders and the International Classification of Functioning: systematic review. BrJP. 2021;4(1):63-7.
16 Von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain. 1992;50(2):133-49.
17 Derogatis LR. SCL-90-R, administration, scoring and procedures manual-II for the R(evised) version and other instruments of the Psychopathology Rating Scale Series. Towson: Clinical Psychometric Research, 1983.
18 Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Jensen R, John MT, De Laat A, de Leeuw R, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/ TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014;28(1):6-27.
19 Ferreira CL, Silva MA, Felício CM. Signs and symptoms of temporomandibular disorders in women and men. Codas. 2016;28(1):17-21.
20 Silva LM, Nobre LS, Rodrigues LL, Valadas LA, Leite TB, Guimarães AS. Diagnosis of temporomandibular dysfunction subtypes in a population seeking specialized care. BrJP. 2023;6(1):16-20.
21 Monteiro DR, Zuim PR, Pesqueira AA, Ribeiro Pdo P, Garcia AR. Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students. J Prosthodont Res. 2011;55(3):154-8.
22 Nixdorf DR, Hemmaty A, Look JO, Schiffman EL, John MT. Electric toothbrush application is a reliable and valid test for differentiating temporomandibular disorders pain patients from controls. BMC Musculoskelet Disord. 2009;10:94.
23 Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10(9):895-926.
24 Kreling MC, da Cruz DA, Pimenta CA. Prevalence of chronic pain in adult workers. Rev Bras Enferm. 2006;59(4):509-13
25 Silva CB, Henn CG, Bonacina CM, Bavaresco CS. Frequency of temporomandibular disorders (TMD) and their relationship with anxiety and depression among dental patients of a Health Care Unit. Rev APS. 2014;17(4):516-22.
26 Soares LF, Coelho LM, Moreno A, Almeida DA, Bonjardim LF. Anxiety and depression associated with pain and discomfort of temporomandibular disorders. BrJP. 2020;3(2):147-52.
27 Tombini N. A arte de ser infeliz: desarmando armadilhas emocionais. Porto Alegre: Citadel Editora, 2017.
28 Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, Dubner R, Diatchenko L, Meloto CB, Smith S, Maixner W. Painful Temporomandibular disorder: decade of discovery from OPPERA Studies. J Dent Res. 2016;95(10):1084-92.
29 Yap AU, Tan KB, Chua EK, Tan HH. Depression and somatization in patients with temporomandibular disorders. J Prosthet Dent. 2002;88(5):479-84.
30 Bueno CH, Pereira DD, Pattussi MP, Grossi PK, Grossi ML. Gender differences in temporomandibular disorders in adult populational studies: A systematic review and meta-analysis. J Oral Rehabil. 2018;45(9):720-9.
31 Freeman A, Stanko P, Berkowitz LN, Parnell N, Zuppe A, Bale TL, Ziolek T, Epperson CN. Inclusion of sex and gender in biomedical research: survey of clinical research proposed at the University of Pennsylvania. Biol Sex Differ. 2017;8:22.
32 Minervini G, Franco R, Marrapodi MM, Fiorillo L, Cervino G, Cicciù M. Economic inequalities and temporomandibular disorders: A systematic review with meta-analysis. J Oral Rehabil. 2023;50(8):715-23.
33 Zheng Y, Zhou X, Huang Y, Lu J, Cheng Q, Fan P, Xiong X. Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders. J Oral Rehabil. 2023;50(12):1373-81
34 Landefeld JC, Burmaster KB, Rehkopf DH, Syme SL, Lahiff M, Adler-Milstein S, Fernald LC. The association between a living wage and subjective social status and self-rated health: a quasi-experimental study in the Dominican Republic. Soc Sci Med. 2014;121:91-7.
35 da Cunha RV, Bastos GA, Del Duca GF. Prevalence of depression and associated factors in a low income community of Porto Alegre, Rio Grande do Sul. Rev Bras Epidemiol. 2012;15(2):346-54.
Submitted date:
01/22/2024
Accepted date:
03/15/2024
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