The Effects Of An Early Intervention Program On Physical Symptoms In A TMD Population

Abstract

Aims: 1) Identify comorbid, non-specific symptoms of CSS, and TMD specific symptoms across three groups of Axis I RDC/TMD disorders, 2) investigate the influence of three interventions on TMD specific and comorbid symptoms of CSS and pain and pain-related disability, and 3) examine the influence of emotional distress on symptoms, pain, and pain-related disability. Methods: Participants were patients recruited from dental clinics within a major metropolitan area assessed for TMD nonspecific symptoms of CSS using the Symptoms Checklist (Study 1) and TMD specific symptoms using the RDC/TMD (Study 2). In Study 2, participants at high-risk for chronicity were randomly assigned to a self-care (SC) or biobehavioral (BB) intervention and evaluated for their responsiveness immediately following treatment (T2). Results: In Study 1, we found that those with a TMD Muscle Disorder and those with more than one TMD diagnosis had more symptoms of CSS. As predicted in Study 2, symptoms for Axis I Group I Muscle Disorders and Axis I Group III Bone Deficiencies and several of the target variables therewithin were significantly reduced immediately following Treatment. Moreover, emotional distress accounted for a substantial amount of the variance for physical symptoms and mediated comorbid symptoms of CSS. Conclusions: Comorbid symptoms are strongly related to myofacial TMD. Axis I Group I and Group III disorders are more responsive to the effects of intervention immediately following treatment compared to Axis I Group II Disc Displacements. Key words: temporomandibular disorder (TMD), myofacial TMD, central sensitization syndrome (CSS), biobehavioral, emotional distress.