Putative Psychosocial Factors Associated with Facial/TMD Pain - Longitudinal Data

There is a paucity of longitudinal data exploring putative TMD risk factors. Previously we reported Caucasians had a significantly higher prevalence of temporomandibular disorders (TMDs) symptoms than African Americans (Plesh et al., 2002) after adjusting for socioeconomic status (SES). Objective: To investigate the relationship of self-reported facial pain/TMD symptoms with longitudinally collected psychosocial measures from a biracial population of young women. Methods: 830 women (50% Caucasian, 50% African-American), 19-23 years old from a established community dwelling cohort in Contra Costa County, California were given the Life Pain History Questionnaire (von Korff et al., 1988), including questions on facial/jaw pain: 6 month prevalence, frequency, duration, intensity, interference and jaw symptoms (e.g. bruxism, chewing pain). This study joins the ongoing, 10 year longitudinal National Heart, Lung and Blood Institute Growth and Health Study (NGHS), which collected information on depression (including CES-D), stress, and coping strategies (e.g. self-criticism, wishful thinking, social contact, social withdrawal) up to 5 times when they were adolescents. SES measures included 1988 Federal poverty category, as well as participant education. Logistic regression models with odds ratios (ORs) 95% confidence intervals (CIs) were utilized for comparisons adjusting for SES and race. Results: Greater depression at the last visit (age 18-19) was significantly related to 6 month pain prevalence (OR=1.6; 95% CI: 1.2-2.0) with Caucasians having higher pain prevalence (OR=2.1; 95% CI: 1.1-3.8) and depression; a race x depression interaction of degree was evident but no longer statistically significant after adjusting for SES. Stress measured biennially over 10 years was unrelated to all facial pain characteristics before (p >.17) or after (p >.28) adjusting for household income, participant education and race. Conclusions: Higher depression scores were related to subsequent self-reported facial pain 1.5 to 2 years later; Caucasians had more self-reported facial/TMD pain than African-Americans. Support: NIH/NIDCR R03-DE12531, R01-DE13487.