IADR Abstract Archives
Trauma and TMD Onset: Descriptive Characteristics from the OPPERA Study
Objectives: To describe the types and frequency of jaw-related trauma among U.S. adult volunteers in the OPPERA study (Orofacial Pain: Prospective Evaluation and Risk Assessment).
Methods: The OPPERA prospective cohort study enrolled 2,737 community-based volunteers at four U.S. study sites. At enrollment, they had no lifetime experience of painful temporomandibular disorder (TMD), and examiners confirmed absence of clinical TMD. During the median 3-year follow-up period, participants completed quarterly (3-monthly) questionnaires assessing trauma that has potential for jaw injury itself. The quarterly questionnaire also screened for TMD-related pain, and symptomatic participants were re-examined, yielding 249 incident cases of first-onset TMD. Contemporaneously, 192 controls who developed neither TMD symptoms nor clinical TMD were identified and re-examined.
Results: At enrollment, subjects were aged 18-44 years (mean=28.7 years) and 65% were female. History of jaw injury before enrollment was reported by 10% of incident cases and of controls. During follow-up, incident cases were more likely than controls to report jaw injury caused by yawning (20% of cases vs. 8% of controls) or prolonged mouth opening (23% vs. 6%). They also reported greater frequency of: sports trauma or falls (9% of cases vs. 3% of controls), shoulder/neck trauma (10% vs. 2%) and trauma to the head (7% vs. 3%). However, cases and controls reported similar frequency of: motor vehicle collisions (10% vs. 10%), whiplash (2% vs. 2%), oral intubation (2% vs. 2%), and tooth extraction or dental treatment (25% vs. 20%). One or more types of injury at any quarterly questionnaire during follow-up was reported by 36% of cases and 12% of controls.
Conclusions: During the 3-year observation period, jaw-related trauma and injury occurred 3 times as frequently in adults who developed TMD than in controls who remained TMD-free. Yawning and prolonged opening were the most frequent forms of injury to the jaw.
Methods: The OPPERA prospective cohort study enrolled 2,737 community-based volunteers at four U.S. study sites. At enrollment, they had no lifetime experience of painful temporomandibular disorder (TMD), and examiners confirmed absence of clinical TMD. During the median 3-year follow-up period, participants completed quarterly (3-monthly) questionnaires assessing trauma that has potential for jaw injury itself. The quarterly questionnaire also screened for TMD-related pain, and symptomatic participants were re-examined, yielding 249 incident cases of first-onset TMD. Contemporaneously, 192 controls who developed neither TMD symptoms nor clinical TMD were identified and re-examined.
Results: At enrollment, subjects were aged 18-44 years (mean=28.7 years) and 65% were female. History of jaw injury before enrollment was reported by 10% of incident cases and of controls. During follow-up, incident cases were more likely than controls to report jaw injury caused by yawning (20% of cases vs. 8% of controls) or prolonged mouth opening (23% vs. 6%). They also reported greater frequency of: sports trauma or falls (9% of cases vs. 3% of controls), shoulder/neck trauma (10% vs. 2%) and trauma to the head (7% vs. 3%). However, cases and controls reported similar frequency of: motor vehicle collisions (10% vs. 10%), whiplash (2% vs. 2%), oral intubation (2% vs. 2%), and tooth extraction or dental treatment (25% vs. 20%). One or more types of injury at any quarterly questionnaire during follow-up was reported by 36% of cases and 12% of controls.
Conclusions: During the 3-year observation period, jaw-related trauma and injury occurred 3 times as frequently in adults who developed TMD than in controls who remained TMD-free. Yawning and prolonged opening were the most frequent forms of injury to the jaw.