Co-morbid Diagnosis, Sleep, Pain and Psychometric Inventories Comparing Dental Populations

Objective: This pilot study examined whether differences in sleep quality, pain, and psychological parameters existed between orofacial pain and general dentistry populations, and tested a newly created inventory assessing 13 medical conditions that were hypothesized to be co-morbid with orofacial pain. Methods: Patients reporting for evaluation at the Orofacial Pain Center (OPC) or the General Dentistry Department (GDD) comprised the comparison groups. Patients who elected to participate in the study completed forms that assessed: (1) sleep quality (Pittsburgh Sleep Quality Index), (2) pain effects (Multidimensional Pain Inventory), (3) psychological parameters (Symptom Checklist-90-Revised), and (4) a Co-morbid Condition Inventory developed by the OPC. Results: 59 participants (41 females and 18 males) were recruited for the OPC group and 44 participants (28 males and 16 females) for the GDD group. T-test analysis differentiated OPC individuals from GDD individuals (P <0.05) on the basis of: (1) greater sleep dysfunction, (2) greater suffering, pain severity, life interference, loss of control, affective distress, impaired social activity and reduced physical activity, and (3) more somatization, obsessive compulsive behavior, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The Co-morbid Condition Inventory differentiated the two groups on the following conditions: fibromyalgia, panic, gastroesophageal reflux disorder, multiple chemical sensitivity, chronic fatigue syndrome, migraine, rebound headache, chronic daily headache and temporomandibular disorders. Conclusions: This study demonstrated that orofacial pain patients could be distinguished from patients seeking annual dental exams on the basis of sleep quality, pain measures, and psychological parameters that may represent dysregulated autonomic nervous system physiology. They can also be differentiated on the basis of symptoms for 9 of 13 medical conditions assessed by the Co-morbid Condition Inventory. These findings indicate that orofacial pain patients present with symptoms suggestive of conditions that may likely signal physiological changes influencing multiple organ systems.