Relation of painful TMD with the speech function: What are the possible characteristics of mandibular movements and the main symptoms reported?

Melissa De Oliveira Melchior,Laís Valencise Magri,Marcelo Oliveira Mazzetto

doi:10.1590/2317-1782/20182018161

Melissa De Oliveira Melchior, Laís Valencise Magri + Show 1 more

Open Access

https://doi.org/10.1590/2317-1782/20182018161

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Abstract

To analyze the mandibular movements of patients with painful TMD during the speech function in order to understand possible alterations and which subgroups of patients may present them. In addition to identifying which signs and symptoms related to painful TMD are perceived in the performance of this function. Thirty-two subjects aged between 18-60 years old (35.1 ± 8.9), 23 with TMD ( DC/TMD; eight men and 15 women) and nine controls were evaluated regarding: self-perception of TMD signs and symptoms during speech (ProTMDMulti); range of mandibular movements during the reading of a word list (electrognatography, Jaw Motion Analyzes). The percentage of movement usage during the speech performance as a function of maximum individual amplitude was calculated, and groups of patients with painful TMD (TMD-D) and painful/joint (TMD-D/A) were subdivided. The TMD-D/A group presented a higher percentage of use of lateral movement during speech than the other groups. Pain, joint noise, and difficulty in speaking were the most commonly reported signs/symptoms of speech performance. The perception of joint noises and the presence of lateral deviations were significantly higher in the TMD-D/A group (p<0.05). The lateral deviations are the main alteration of the mandibular movement during the speech performance in painful TMD. Such deviations are more expected in joint TMD (disc displacement and degenerative diseases). The perception of pain and joint noise are the main complaints related to the orofacial speech function in individuals with painful TMD.

Highlights

Temporomandibular disorders (TMD) are characterized by localized pain in the face and pre-auricular region, and/or by limitations or interferences in the mandibular movements, in addition to joint noises
The results of this study demonstrated that, during the speech performance, individuals with painful TMD perceive signs and symptoms, especially muscle/joint pain and temporomandibular joints (TMJ) noises, the scores attributed by them are low
The main change in the mandibular movement during speech in individuals with painful TMD is the lateral deviations. Such deviations are more expected in TMD cases with joint involvement

Summary

Introduction

Temporomandibular disorders (TMD) are characterized by localized pain in the face and pre-auricular region, and/or by limitations or interferences in the mandibular movements, in addition to joint noises. The impacts on speech, according to the analysis of the narratives of patients with TMD, were related to pain, avoidance of speech, professional losses and the need for phonoarticulatory adaptations during the oral communication, leading to social, emotional and labor implications[6]. This interaction of the emotional and cognitive aspects with the motor behavior and the painful perception end up influencing the functional capacity and quality of life of patients with painful TMD[7,8], being relevant its investigation to the understanding of the diagnostic and delineation of specific conducts[4,9]

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