Temporomandibular disorders cases with high-impact pain are more likely to experience short-term pain fluctuations

Sci Rep. 2022 Jan 31;12(1):1657. doi: 10.1038/s41598-022-05598-w.


Temporomandibular disorders (TMD) patients can present clinically significant jaw pain fluctuations which can be debilitating and lead to poor global health. The Graded Chronic Pain Scale evaluates pain-related disability and its dichotomous grading (high/low impact pain) can determine patient care pathways and in general high-impact pain patients have worse treatment outcomes. Individuals with low-impact TMD pain are thought to have better psychosocial functioning, more favorable disease course, and better ability to control pain, while individuals with high-impact pain can present with higher levels of physical and psychological symptoms. Thereby, there is reason to believe that individuals with low- and high-impact TMD pain could experience different pain trajectories over time. Our primary objective was to determine if short-term jaw pain fluctuations serve as a clinical marker for the impact status of TMD pain. To this end, we estimated the association between high/low impact pain status and jaw pain fluctuations over three visits (≤ 21-day-period) in 30 TMD cases. Secondarily, we measured the association between jaw pain intensity and pressure pain thresholds (PPT) over the face and hand, the latter measurements compared to matched pain-free controls (n = 17). Jaw pain fluctuations were more frequent among high-impact pain cases (n = 15) than low-impact pain cases (n = 15) (OR 5.5; 95% CI 1.2, 26.4; p value = 0.033). Jaw pain ratings were not associated with PPT ratings (p value > 0.220), suggesting different mechanisms for clinical versus experimental pain. Results from this proof-of-concept study suggest that targeted treatments to reduce short-term pain fluctuations in high-impact TMD pain is a potential strategy to achieve improved patient perception of clinical pain management outcomes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Case-Control Studies
  • Chronic Pain / diagnosis
  • Chronic Pain / physiopathology*
  • Cost of Illness
  • Facial Pain / diagnosis
  • Facial Pain / physiopathology*
  • Female
  • Humans
  • Jaw / innervation*
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain Threshold*
  • Proof of Concept Study
  • Temporomandibular Joint Disorders / diagnosis
  • Temporomandibular Joint Disorders / physiopathology*
  • Time Factors
  • Young Adult