Painful temporomandibular disorders (TMDs) are both consequence and cause of change in multiple clinical, psychosocial, and biological factors. Although longitudinal studies have identified antecedent biopsychosocial factors that increase risk of the TMD onset and persistence, little is known about long-term change in those factors after TMD develops or remits. During a 7.6-year median follow-up period, we measured change in psychosocial characteristics, pain sensitivity, cardiovascular indicators of autonomic function, and clinical jaw function among 189 participants whose baseline chronic TMD status either persisted or remitted and 505 initially TMD-free participants, 83 of whom developed TMD. Among initially TMD-free participants who developed TMD, symptoms and pain sensitivity increased, whereas psychological function worsened. By contrast, participants with chronic TMD at baseline tended to show improved TMD symptoms, improved jaw function, reduced somatic symptoms, and increased positive affect. In general, clinical and psychosocial variables more frequently changed in parallel with TMD status compared with pain sensitivity and autonomic measures. These findings demonstrate a complex pattern of considerable changes in biopsychosocial function associated with changes in TMD status. In particular, several biopsychosocial parameters improved among participants with chronic TMD despite pain persisting for years, suggesting considerable potential for ongoing coping and adaptation in response to persistent pain.
In this longitudinal study, changes in temporomandibular disorder status were associated with changes in biopsychosocial characteristics among participants with and without TMD at baseline.
aPain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, United States
bDepartment of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, United States
cCenter for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
Departments of dDental Ecology and
eEpidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
fDepartment of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
gBrotman Facial Pain Clinic, University of Maryland School of Dentistry, Baltimore, MD, United States
hCenter for Translational Pain Medicine, Duke University, Durham, NC, United States
Departments of iBiostatistics and
jEndodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
kDepartment of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, United States
Corresponding author. Address: UF Pain Research and Intervention Center of Excellence, Clinical and Translational Research Building (CTRB), Room 3216, 2004 Mowry Rd, PO Box 100404, Gainesville, FL 32610-0404, United States. Tel.: (352) 273-5963. E-mail address: firstname.lastname@example.org (R.B. Fillingim).
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Received April 26, 2018
Received in revised form July 11, 2018
Accepted July 13, 2018