Jaw Fatigue Research Articles

Risk factors associated with symptoms of temporomandibular disorders among women with hypermobile Ehlers-Danlos syndrome: Questionnaire-based study in Finland and Sweden.

Generalized joint hypermobility as a characteristic feature of Ehlers-Danlos syndromes (EDS) is among the factors contributing to temporomandibular disorders (TMD). To evaluate the prevalence of TMD symptoms and their risk factors among women born in Sweden or Finland who were 27- to 78-year-olds with diagnosed hypermobile EDS (hEDS). A cohort of women with confirmed hEDS (n = 185) was constructed from the members of the National EDS Associations in both countries. Based on questionnaire data, frequency of independent variables in terms of socio-demographic, general health and oral health-related factors, comorbid symptoms and psychological distress for self-reported TMD symptoms as the dependent variables, were calculated first. Prevalence ratios (PR) and their 95% confidence interval (95% CI) were estimated for the association between independent and dependent variables. Nearly all participants reported TMD symptoms (98%) with TMD pain (95%), TMJ clicking (90%) and jaw fatigue (80%) as the most common symptoms and TMJ crepitation (63%) and luxation (44%) as the least common symptoms. Risk factors for TMD among 27- to 50-year-olds participants were Finland as a country of birth, living alone and self-reported worst pain in the body (not the joints). The respective risk factors among the 51- to 78-year-olds were Finland as a country of birth, family history of EDS, tinnitus and regularly taking contraceptives. Among adult women with confirmed hEDS, socio-demographic and health-related factors and comorbid symptoms were significantly associated with TMD but with differences regarding age group. Therefore, management of TMD requires a multidisciplinary approach among the affected.

The Arabic Fonseca Anamnestic Index: Psychometric properties and use for screening temporomandibular disorders in prospective orthodontic patients

ABSTRACT Objective This study aimed to develop/evaluate the psychometric properties of the Arabic Fonseca Anamnestic Index (FAI-A) and estimate the prevalence of TMDs in prospective orthodontic patients. Methods The FAI-A was derived by forward-backward translation/cross-cultural adaption of the English FAI. Psychometric assessment of the FAI-A was performed with 308 orthodontic patients. Reliability was established via internal consistency and test-retest techniques, whereas, validity was verified by construct and convergent validity. Results Cronbach’s alpha value for the FAI-A was 0.77, and the intraclass correlation coefficient was 0.99. For construct validity, the distribution of eigenvalues indicated that three items (mouth opening difficulty, jaw movement difficulty, and jaw fatigue) accounted for 60.5% of the total variance observed. For convergent validity, the FAI-A items were significantly correlated to the global question. Conclusion The FAI-A showed good reliability/validity and may be useful for screening TMDs. About 17% of prospective orthodontic patients presented with moderate-to-severe TMD symptoms.

Temporal Arteritis Related Arteritic Anterior Ischemic Optic Neuropathy

Temporal arteritis (Giant cell arteritis) is an autoimmune systemic disease affecting the elderly population characterized by granulomatous vasculitis involving the mid-large size vessels. Classical systemic symptoms include headache, skin sensitivity in the temporal region, and jaw fatigue. Inflammation involving the posterior ciliary arteries leads to arteritic anterior ischemic optic neuropathy which causes sudden vision loss. Temporal artery biopsy is the gold standard for diagnosis and should be applied to all patients suspected of the disease. As early diagnosis and treatment are of vital importance in terms of improvement of visual loss and prevention of other ocular involvement, Optic neuropathy is considered to be a neuro-ophthalmologic emergency. The gold standard in treatment is steroids. There is no consensus in the literature regarding the optimal therapeutic approach in cases with steroid resistance. Biological agents, especially tocilizumab, are promising in refractory cases. Up-to-date steroids are the first step in the treatment algorithm, tocilizumab is recommended in the second line; however, in cases with progression, abatacept, ustekinumab, and anakinra are recommended as last-line treatments.

How dental team members describe adverse events

BackgroundAlthough some patients experience adverse events (AEs) resulting in harm caused by treatments in dentistry, few published reports have detailed how dental providers describe these events. Understanding how dental treatment professionals view AEs is essential to building a safer environment in dental practice. MethodsThe authors interviewed dental professionals and domain experts through focus groups and in-depth interviews and asked them to identify the types of AEs that may occur in dental settings. ResultsThe initial interview and focus group findings yielded 1,514 items that included both causes and AEs. In total, 632 causes were coded into 1 of the 8 categories of the Eindhoven classification, and 882 AEs were coded into 12 categories of a newly developed dental AE classification. Interrater reliability was moderate among coders. The list was reanalyzed, and duplicate items were removed leaving a total of 747 unique AEs and 540 causes. The most frequently identified AE types were “aspiration and ingestion” at 14% (n = 142), “wrong-site, wrong-procedure, wrong-patient errors” at 13%, “hard-tissue damage” at 13%, and “soft-tissue damage” at 12%. ConclusionsDental providers identified a large and diverse list of AEs. These events ranged from “death due to cardiac arrest” to “jaw fatigue from lengthy procedures.” Practical ImplicationsIdentifying threats to patient safety is a key element of improving dental patient safety. An inventory of dental AEs underpins efforts to track, prevent, and mitigate these events.

일부 남자 고등학생의 측두하악장애 관련 증상의 유병률과 구강악습관 및 컴퓨터 이용시간과의 관계 연구

Objectives : The purpose of the study is to verify the correlation between teenagers' use of internet and temporomandibular joint disorders(TMJD) because TMJD patients gradually increase in high school students. Methods : Subjects were 221 male high school students attending liberal arts and commercial schools from 9 to 21 of April, 2012. Students completed self-reported questionnaire. Results : TMJD symptoms included crackling joint (32.1%), headache (18.6%), malocclusion (8.1%), and jaw fatigue and muscular aching (7.2%). Students having at least one symptom accounted for 49.8%. Students having at least one poor habit accounted for 83.7% and 34.0% of the students used internet for 3 hours.. Score of students experiencing shoulders and chest pain was <TEX>$5.13{\pm}1.10$</TEX> (p<0.05). Score of TMD afflicting area revealed <TEX>$4.67{\pm}2.73$</TEX> (p<0.05) in mastication pain (<TEX>$4.13{\pm}2.73$</TEX> (p<0.05)) due to long hours of internet use. Score of jaw fatigue related to muscular pain was <TEX>$4.31{\pm}1.96$</TEX> (p<0.01). Duration of computer use was related to perceived TMJD symptoms (r=.153). Long duration of computer use was related to poor oral cavity habits (r=.157). Conclusions : Male high school students can perceive slight TMD which needs self management and regular check-ups and try to prevent TMD by utilizing measurement tools on TMD. Also, this study helps to prevent from worsening TMD by shortening hours of computer utilization.

Monocular Vision Loss and Headache in a 60-Year-Old Liver Transplant Patient

Monocular Vision Loss and Headache in a 60-Year-Old Liver Transplant Patient

Association between jaw fatigue and occlusion

We investigated the association between jaw fatigue and occlusion via an initial questionnaire. The subjects were divided into six groups based on overbite of the anterior teeth and the anteroposterior skeletal relationship between the maxilla and mandible: Open bite + skeletal Class I group (O-I group), Open bite + skeletal Class II group (O-II group), Open bite + skeletal Class III group (O-III group), Deep bite + skeletal Class I group (D-I group), Deep bite + skeletal Class II group (D-II group), and Deep bite + skeletal Class III group (D-III group). In addition, we randomly selected skeletal Class I patients with a positive overjet/overbite of equal or less than 2 mm from patients with malocclusion, as N-I group. In each group, we examined the presence or absence of jaw fatigue both in case of jaw movement during mastication and conversation, and at rest position. Then we compared the proportion of patients with the symptom. In all Open/Deep bite groups, the proportions of patients with jaw fatigue on movement were significantly higher than that in the N-I group. For jaw fatigue at rest, the proportion of patients of D-III group was significantly higher than those in the N-I, D-I, D-II, and O-III groups. Thus, the open/deep bite patients complaining of jaw fatigue during mastication/conversation, and the deep bite + skeletal Class III patients at rest position, suggest an association between the vertical/horizontal occlusal relationship and jaw fatigue.

Factors Related to Patients' Anxiety Before and After Oral Surgery

The purpose of this study was to identify factors that may contribute to anxiety of patients undergoing minor oral surgery before and after the operation. A total of 120 patients who underwent minor oral surgery were included in the study. Each patient's anxiety was measured using Spielberger's State-Trait Anxiety Inventory and Corah's Dental Anxiety Scale immediately before, immediately after, and 1 week after the operation. Anxiety levels for each given situation about the surgery were determined using visual analog scales. The effects of various factors, such as demographic variables, previous dental experience, and postoperative complaints, on anxiety were also analyzed. Postoperative anxiety levels were significantly lower than the preoperative anxiety levels (P<.001). Patients recorded higher anxiety levels for "jaw becoming tired" and "collection of fluid in the mouth" than for "feeling pain during the operation" both before and after the operation. There was a positive correlation between pain expectation with preoperative anxiety and pain actually experienced during surgery with postoperative anxiety (P<.001). Whereas patients' trait anxiety and previous dental experience were correlated with preoperative anxiety (P<.001 and P<.05, respectively), no relationship with postoperative anxiety was found. The difficulty of the procedure was not correlated with anxiety immediately after the operation but was correlated with anxiety during the follow-up visit (P<.05). Postoperative complaints were related to the dental anxiety levels recorded 1 week after surgery (P<.05). To reduce patients' anxiety, underestimated factors, such as jaw fatigue and fluid collection in the mouth, should be taken into account during oral surgery under local anesthesia. In the postoperative period, swelling and difficulty in eating, as well as pain, should also be considered in relieving patients' anxiety.

A 20-year longitudinal study of subjective symptoms of temporomandibular disorders from childhood to adulthood

The aims were to study the development over 20 years of reported temporomandibular disorders (TMD) symptoms in an epidemiologic sample and to analyze possible correlations between these symptoms and some other variables. Four hundred and two randomly selected 7-, 11-, and 15-year-old subjects were originally examined by means of a questionnaire with regard to symptoms of TMD. The investigation was repeated after 4-5, 10, and 20 years, using the same method. After 20 years, when the original group had reached the age of 27 to 35 years, 378 individuals (94%) could be traced, and they were sent a questionnaire. Three hundred and twenty subjects (80% of the original sample, 85% of the traced subjects) completed and returned the questionnaire. There was a substantial fluctuation of reported symptoms over the 20-year period. Progression to severe pain and dysfunction of the masticatory system was rare. On the other hand, recovery from frequent symptoms to no symptoms was also rare. At the last examination 13% reported one or more frequent TMD symptom. The prevalence of bruxism increased with time, but other oral parafunctions decreased. Women reported TMD symptoms and headache more often than men. Correlations between the studied variables were mainly weak. The highest correlations found (rs = 0.4-0.5) were those between reported tooth clenching and tooth grinding and jaw fatigue. It can be concluded that in this epidemiologic sample, followed over 20 years from childhood to adulthood, a substantial fluctuation of TMD symptoms was found. Severe symptoms were rare, but 1 of 8 subjects reported frequent TMD symptoms at the last exam.

Tinnitus: Evaluation of biofeedback and stomatognathic treatment

Thirty-two patients with disabling tinnitus received stomatognathic treatment and biofeedback therapy according to a cross-over design. The evaluation of treatment outcomes showed some improvements at the group level: decrease of tinnitus intensity, mood improvement and reduction of clinical signs of dysfunction in the masticatory system. Qualitative observations indicated numerous positive changes in patients' emotional and cognitive orientation vis à vis tinnitus. Some possible predictors of positive treatment outcome were observed: comparatively low severity of tinnitus, normal hearing or compensated hearing loss, occlusal interferences, jaw fatigue, diurnal bruxism and fluctuations in tinnitus intensity. Left-sided tinnitus seemed to be a negative predictor of stomatognathic and biofeedback treatment outcome. Consequently, stomatognathic and biofeedback treatment seem to have some positive effects on subgroups of tinnitus patients.