Do Pain Intensity or Psychological Disorders Impact the Transition Risk From Acute to Chronic painful TMD?

Objectives: Aim. Studies demonstrated that pain intensity increases the risk of persistent temporomandibular disorders (TMD) pain. The aim of the study was to determine if pain intensity or psychological factors are associated with transition from acute to chronic TMD pain at 3 months of follow-up.

Methods: Method. Participants with painful TMD were recruited from four dental clinics in Montreal, Canada: Oral Diagnosis clinic of McGill University, Orofacial Pain clinic of the Montreal General Hospital, the dental clinic of the JGH and a dental clinic in Ottawa. Participants received the diagnosis of TMD based on the Diagnostic Criteria, and reported their level of pain, and depression using the Graded Chronic Pain Scale and Personal Health Questionnaire Depression Scale, respectively. The relative risk between putative risk factors and painful TMD was assessed using PROC GENMOD (SAS software).

Results: Results. In the acute TMD pain cohort (< 3 months, n=82 at baseline), 50 subjects presented a transition to chronic TMD pain at 3 months of follow-up. This acute to chronic TMD pain transition was associated with pain intensity at baseline (RR= 1.02, P= 0.01). From the chronic TMD pain cohort (≥ 3 months, n= 317), 252 subjects presented a persistent chronic TMD pain at 3 months of follow-up. Pain intensity (RR= 1.03, P=0.03) and female sex (RR=1.28, P=0.006) were associated with the persistence risk. Age and depression were not related to the acute to chronic TMD pain transition or persistence at 3 months of follow-up.

Conclusions: Conclusion. Pain intensity increase the risk of transition from acute to chronic pain, as well as the persistence of TMD pain, regardless of depression status, age and sex covariates.