Modulation of occlusal comfort accompanying with pain and anxiety and depression mood states

• Published in: The Journal of Japanese Society of Stomatognathic Function Vol. 15; no. 1; pp. 8 - 17
• Main Authors: Kino, Koji, Matsumoto, Toshihiko, Kamiya, Kazunobu, Funato, Masahiko, Narita, Noriyuki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Stomatognathic Function 30.10.2008
• Subjects: anxiety and depression mood states; discomfort; modulation; occlusal awareness; pain
• ISSN: 1340-9085; 1883-986X
• DOI: 10.7144/sgf.15.8

Pain and tactile sensation have an interactive relationship, i.e. pain inhibits or facilitates tactile sensation, while tactile sensation inhibits pain sensation. Therefore, TMDs are generally given for pain disorders in the orofacial region that are possibly related to occlusal discomfort. Also, it is clinically reported that psychiatric distress possibly affects to the occlusal discomfort. In this study, we attempted to clarify the relationships between awareness of occlusal comfort and TMD symptoms such as TMJ-noise, TMJ-pain, and jaw movement difficulty, as well as occlusal and psychiatric conditions. The subjects were 135 students. First, we examined TMD symptoms using a diagnostic process composed of an interview and examination, then we classified the subjects into 3 groups; non-symptomatic (n=69), TMJ-noise (n=45), and jaw movement related TMJ-pain (n=21) . In a comparison with the non-symptomatic group, the results of a numerical rating scale (NRS) showing the awareness of TMD symptoms indicated that those with jaw movement related TMJ-pain had significantly aggravated awareness of TMJ-noise, jaw movement related TMJ-pain, and jaw movement difficulty, while the TMJ-noise group had significant aggravated awareness of jaw movement related TMJ-pain and jaw movement difficulty. In addition, subjects with jaw movement related TMJ-pain had a significant decrease in awareness of occlusal comfort demonstrated in NRS findings as compared with the non-symptomatic group, even though there was no significant difference of occlusal contact statues among non-symptomatic, TMJ-noise, and TMJ-pain groups. Next, the 135 subjects were classified into 2 groups, healthy (0-7 points, n=71) and anxiety suspected (8 points or more, n=64), based on anxiety scores obtained with the Hospital Anxiety and Depression Scale (HADS) . NRS results showed that subjects in the anxiety suspected group tended to have an aggravated awareness of occlusal comfort as compared with those in the healthy group, even though there was no significant difference of occlusal contact statues and awareness of TMD symptoms between healthy and anxiety groups. Based on our results, we concluded that awareness of occlusal comfort may be modulated accompanying with the aggravated TMD symptoms such as the occurrence of TMJ pain and anxiety and depression mood states.