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Title Psychologic Characteristics Such As Anxiety Appear To Have A Significant Impact On The Prevalence Of TMD
Clinical Question How significant is anxiety in triggering symptoms of temporomandibular disorders in patients?
Clinical Bottom Line Psychological characteristics such as anxiety, appear to have a significant impact on the prevalence of TMD.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20027126Licini/2009308 subjects 4 female : 1 maleCase series (comparative)
Key resultsPsychological characteristics, including somatization, depression, and anxiety related to gender, appear to have a significant impact on the prevalence of TMD.
#2) 19210679Vedolin/2009 45 female studentsCase control
Key resultsExternal stressors have a potential impact on masticatory muscle tenderness, regardless of the presence of a previous condition such as masticatory myofascial pain.
Evidence Search Search "Anxiety"[Mesh] Search "Temporomandibular Joint Disorders"[Mesh]
Comments on
The Evidence
Article by Licini: Of the 362 subjects evaluated, 308 met the inclusion criteria. This study is based on Research Diagnostic Criteria for TMD (RDC/TM) Axis II diagnosis and analysis of gender-related differences. There was a ratio of 4 females to 1 male in the patient group.Article by Vedolin: 2 Groups of female students (No males in study). Group 1 had 29 patients presenting with masticatory myofascial pain (MFP), according to the Research Diagnostic Criteria for Temporomandibular Disorders. Group 2 had 16 asymptomatic controls. An electronic algometer registered the pain thresholds on four different occasions throughout the academic year. To measure levels of stress, anxiety and pain, the Beck Anxiety Inventory, Lipp Stress Symptoms Inventory and Visual Analog Scale (VAS) were used. Levels of anxiety and VAS were compared using Mann-Whitney test, while Friedman’s test was used for the within-groups comparison at different times (T1 to T4). The chi-squared and Cochran tests were performed to compare groups for the proportion of subjects with stress (alpha = 0.05). Differences in PPT recordings between time (P = 0.001) and sites (P < 0.001) were detected. Higher levels of anxiety and lower PPT figures were detected at T2 (academic examination) (P = 0.001). There was no difference between groups for anxiety and stress at any time (P > 0.05). The MFP group also has shown significant increase of VAS at the time of academic examination (P < 0.001)
Applicability These studies would apply to any patient that has TMD symptoms or any patients who feel extreme anxiety. It shows the relation between stress and TMD symptoms and can help Dentists relate that information to patients with these symptoms.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Behavioral Science)
ID# 857
Date of submission: 03/30/2011spacer
E-mail anandm@livemail.uthscsa.edu
Author Manvir Anand
Co-author(s) e-mail
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail WrightE2@uthscsa.edu
Basic Science Rationale
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Comments and Evidence-Based Updates on the CAT
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by Dayo Adeyinka, DDS, Hijazi Fawzi, DDS (San Antonio, TX) on 11/17/2015
A PubMed and Trip database search on this question in November, 2015 found a more recent publication by Oliveira et al 2015 (PMID: 26039910). This clinical survey was conducted among nursing professionals in a university hospital, to evaluate the association between TMD, anxiety, quality of sleep and quality of life among the subjects. TMD was associated with trait anxiety and its severity was associated with state anxiety. The results further strengthens the conclusion of this CAT.

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