Pain and quality of life in temporomandibular disorders (TMD)

Objectives: To explore the effects of painful compared with non-painful TMD conditions on patients' perceived quality of life. Methods: TMD patients (n= 59, mean age 40, 83% females) diagnosed using the Research Diagnostic Criteria (RDC) for temporomandibular disorders completed Visual Analogue Scales (VAS) for pain and the full version Oral Health Impact Profile (OHIP-49) at the time of diagnosis. Summed OHIP and domain scores were compared between “painful” (RDC groups I, IIIa,b) and “non-painful” conditions (RDC II & IIIc). The latter comprised 15% of patient sample and were characterised by abnormal joint sounds and movement but without reaching the threshold for the other RDC groups. A group of age:sex-matched TMD-free controls (n= 110, mean age 39, 84% females) were tested in the same way. Results: VAS scores for pain differed significantly between pain and non-pain groups, confirming the inclusion criteria for TMD groups. Overall and domain OHIP scores varied significantly (ANOVA, p<0.001) between controls, non-pain and pain groups. Mean overall OHIP scores were 17, 37, 63 respectively on scale of 0-196. Post Hoc ANOVA (Tukey, p<.05) showed that the differences between the pain and control groups were significant in all domains. Significant differences were also seen between the two patient groups in the disability and handicap domains and in the overall OHIP score. Conclusions: Non-painful TMD conditions have a significant impact on patient's quality of life as measured by OHIP, but pain contributes to a higher level of impact, including psychosocial disability and handicap.