Facial pain and temporomandibular disorders
1University of Oulu, Faculty of Medicine, Department of Prosthetic Dentistry and Stomatognathic Physiology
2University of Oulu, Faculty of Medicine, Institute of Dentistry, Department of Oral and Maxillofacial Surgery
3University of Oulu, Faculty of Medicine, Department of Public Health Science and General Practice
4University of Oulu, Faculty of Medicine, Department of Psychiatry
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|Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in the Auditorium of the Institute of Dentistry, on February 15th, 2002, at 12 noon
Professor Hasse Karlsson
Docent Yrsa Le Bell
The study was undertaken to determine the prevalence of facial pain and the association of facial pain with temporomandibular disorders (TMD) as well as with other factors, in a geographically defined population-based sample consisting of subjects born in 1966 in northern Finland, and in a case-control study including subjects with facial pain and their healthy controls. In addition, the influence of conservative stomatognathic and necessary prosthetic treatment on facial pain and TMD was evaluated in a sample of patients with facial pain.
In the age group of 31–32-year-olds, facial pain was reported by 12 % of men and 18 % of women. Reported facial pain was strongly associated with TMD symptoms, and a relation was also seen with other factors, i.e. certain occlusal factors, previous traumas, other pain conditions in the body, clinically assessed tenderness in the neck muscles, and psychological problems, such as depressiveness and alexithymia. Conservative treatment of TMD seemed to be effective in relieving facial pain in a one-year follow-up.
It can be concluded that facial pain is quite a common symptom with several both localized and generalized associated factors. Conservative stomatognathic treatment is recommended in the case of TMD-related facial pain. The possibility of psychological problems should be taken into account, especially in complex and chronic cases. When no response to conservative stomatognathic treatment is achieved, a multidisciplinary team, including mental health professionals, will be needed in both diagnosis and treatment. This study provides support for the suggestion that in future individualizing treatment of the patients with facial pain should be based on patient characteristics, which may improve treatment efficacy.
Acta Universitatis Ouluensis. D, Medica
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