Long-term changes in biopsychosocial characteristics related to temporomandibular disorder: findings from the OPPERA study

Pain. 2018 Nov;159(11):2403-2413. doi: 10.1097/j.pain.0000000000001348.

Abstract

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.

MeSH terms

  • Adult
  • Biophysical Phenomena / physiology*
  • Cardiovascular Physiological Phenomena
  • Cohort Studies
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain Threshold / physiology*
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Social Behavior*
  • Surveys and Questionnaires
  • Temporomandibular Joint Disorders / physiopathology*
  • Temporomandibular Joint Disorders / psychology*