COMPARING SHORT- AND LONG-TERM TMD PAIN COMORBIDITIES: A CROSS-SECTIONAL STUDY AMONG ADOLESCENTS

Abstract

<h3>Objectives</h3> The primary aim of this study was to compare painful and nonpainful comorbidities between short- and long-term temporomandibular disorder (TMD) pain. The secondary aim was to assess the impact of persistent TMD pain on school absence. <h3>Study Design</h3> Adolescents were enrolled in Montreal (Canada), Nice (France), and Arceburgo (Brazil). The presence of TMD pain, comorbidities (i.e., asthma, allergies, back pain, neck pain, stomach pain, and headache), and school absence were assessed using reliable and validated questionnaires. TMD pain lasting <6 months was considered short-term, and that lasting ≥6 month was deemed long-term. Chi-square tests and analysis of variance were used to test statistical differences between adolescents with short- and long-term TMD pain and those without (controls). Univariate and multivariate unconditional nominal logistic regression analyses were used to assess the association between TMD pain (dependent variable) and the independent variables. <h3>Results</h3> This study enrolled 1400 adolescents with short-term (n = 312, 22.29%) and long-term (n = 139, 9.93%) TMD pain and controls (n = 949, 67.79%). The number of comorbidities was associated with short-term (odds ratio [OR] = 1.71; 95% confidence interval [CI], 1.53-1.90) and long-term (OR = 1.79; 95% CI, 1.55-2.08) TMD pain compared with controls. Allergies were only associated with short-term TMD pain (OR = 1.54; 95% CI, 1.13-2.10). In comparison to controls, adolescents with long- and short-term TMD pain were more likely to have frequent headaches (≥once a week; OR short-term = 4.39; 95% CI, 3.23-5.98; OR long-term = 3.69; 95% CI, 2.45-5.57) and frequent back pain (OR short-term = 1.46; 95% CI, 1.06-2.03; OR long-term = 1.69; 95% CI, 1.11-2.59). Frequent stomach pain was only associated with long-term TMD pain (OR = 2.01; 95% CI, 1.35-3.26), whereas frequent neck pain was only associated with short-term TMD pain (OR = 2.23; 95% CI, 1.53-3.26). Adolescents with long-term TMD pain had higher rates of missing school than those with short-term TMD pain (n long-term = 39, 28.26%; n short-term = 48, 15.43%; <i>P</i> = .0015). <h3>Conclusions</h3> Frequent headache and back pain are very common among adolescents with both short- and long-term TMD pain. The specific association between stomach pain and long-term TMD pain suggests a central dysregulation mechanism.