Treating Parafunctional Habits for Alleviating Temporomandibular Disorder and Lower Back Pain: A Phase II Clinical Trial

Overview

Journal Front Dent

Specialty Dentistry

Date 2023 Jun 14

PMID 37312825

Authors

Farzaneh Agha-Hosseini

Iraj Mirzaii-Dizgah

Shiva Shirazian

Maryam Javaheri-Mahd

Affiliations

Soon will be listed here.

Abstract

Temporomandibular disorders (TMDs) include a series of signs and symptoms in the temporomandibular joints (TMJ) and muscles of mastication, which are associated with or caused by parafunctional habits. Many of these patients also suffer from lumbar pains. This study aimed to evaluate the effectiveness of treating parafunctional habits in alleviating symptoms of TMD and lower back pain. This phase II clinical trial was conducted on 136 patients suffering from TMDs and lumbar pain, who consented to participate in this study. They were provided with instructions on how to discontinue their parafunctional habits including clenching and bruxism. The Helkimo and Rolland Morris questionnaires were used to assess TMD and lower back pain, respectively. Data were statistically analyzed using paired Student's t-test, Wilcoxon, Mann-Whitney, and Spearman correlation tests, with the significance level set at P<0.05. The mean severity score of TMD significantly decreased after the intervention. Following treatment of TMD, the mean severity score of lumbar pain decreased from 8 to 2 (P=0.0001). Based on our findings, it appears that the elimination of parafunctional habits improves TMD and lumbar pain.

References

Altindag O, Gur A, Altindag A . The relationship between clinical parameters and depression level in patients with myofascial pain syndrome. Pain Med. 2008; 9(2):161-5. DOI: 10.1111/j.1526-4637.2007.00342.x. View

Nayha S, Videman T, Laakso M, Hassi J . Prevalence of low back pain and other musculoskeletal symptoms and their association with work in Finnish reindeer herders. Scand J Rheumatol. 1991; 20(6):406-13. DOI: 10.3109/03009749109096819. View

Feng Lim P, Smith S, Bhalang K, Slade G, Maixner W . Development of temporomandibular disorders is associated with greater bodily pain experience. Clin J Pain. 2010; 26(2):116-20. PMC: 2811336. DOI: 10.1097/AJP.0b013e3181c507ef. View

Kuc J, Szarejko K, Golebiewska M . The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral-A Pilot Study. Int J Environ Res Public Health. 2021; 18(18). PMC: 8471332. DOI: 10.3390/ijerph18189842. View

Winocur E, Gavish A, Finkelshtein T, Halachmi M, Gazit E . Oral habits among adolescent girls and their association with symptoms of temporomandibular disorders. J Oral Rehabil. 2001; 28(7):624-9. DOI: 10.1046/j.1365-2842.2001.00708.x. View

Hill J, Keating J . Risk factors for the first episode of low back pain in children are infrequently validated across samples and conditions: a systematic review. J Physiother. 2010; 56(4):237-44. DOI: 10.1016/s1836-9553(10)70006-0. View

Cooper B . Temporomandibular disorders: A position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio. 2012; 29(3):237-44. DOI: 10.1179/crn.2011.034. View

Lee K, Wu Y, Chien W, Chung C, Chen L, Shieh Y . The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up. Medicine (Baltimore). 2020; 99(3):e18686. PMC: 7220485. DOI: 10.1097/MD.0000000000018686. View

Ingervall B . Functionally optimal occlusion: the goal of orthodontic treatment. Am J Orthod. 1976; 70(1):81-90. DOI: 10.1016/0002-9416(76)90262-1. View

10.

Wiesinger B, Malker H, Englund E, Wanman A . Does a dose-response relation exist between spinal pain and temporomandibular disorders?. BMC Musculoskelet Disord. 2009; 10:28. PMC: 2653030. DOI: 10.1186/1471-2474-10-28. View

11.

Mousavi S, Parnianpour M, Mehdian H, Montazeri A, Mobini B . The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006; 31(14):E454-9. DOI: 10.1097/01.brs.0000222141.61424.f7. View

12.

Kim D, Ko S, Lee E, Jung B . The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study. BMC Musculoskelet Disord. 2019; 20(1):631. PMC: 6935481. DOI: 10.1186/s12891-019-3003-4. View

13.

Silveira A, Armijo-Olivo S, Gadotti I, Magee D . Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability. J Oral Facial Pain Headache. 2014; 28(2):138-46. DOI: 10.11607/ofph.1112. View

14.

Pergamalian A, Rudy T, Zaki H, Greco C . The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders. J Prosthet Dent. 2003; 90(2):194-200. DOI: 10.1016/s0022-3913(03)00332-9. View

15.

Wiesinger B, Malker H, Englund E, Wanman A . Back pain in relation to musculoskeletal disorders in the jaw-face: a matched case-control study. Pain. 2007; 131(3):311-319. DOI: 10.1016/j.pain.2007.03.018. View

16.

Agha-Hosseini F, Sheykhbahaei N, Mirzaii-Dizgah I, Fatehi F . The efficacy of oral habit modification on headache. J Korean Assoc Oral Maxillofac Surg. 2018; 43(6):401-406. PMC: 5756797. DOI: 10.5125/jkaoms.2017.43.6.401. View

17.

Winocur E, Littner D, Adams I, Gavish A . Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescents: a gender comparison. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102(4):482-7. DOI: 10.1016/j.tripleo.2005.11.007. View

18.

Halliwell B . Oxygen radicals, nitric oxide and human inflammatory joint disease. Ann Rheum Dis. 1995; 54(6):505-10. PMC: 1009913. DOI: 10.1136/ard.54.6.505. View

19.

Panjabi M . The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992; 5(4):383-9; discussion 397. DOI: 10.1097/00002517-199212000-00001. View

20.

Bonjardim L, Gaviao M, Carmagnani F, Pereira L, Castelo P . Signs and symptoms of temporomandibular joint dysfunction in children with primary dentition. J Clin Pediatr Dent. 2003; 28(1):53-8. DOI: 10.17796/jcpd.28.1.0772w75g91963670. View