Menstrual Variation in Pulp Sensitivity in Women with Temporomandibular Disorders

Objectives: To explore menstrual changes in dental pulp sensitivity in women with temporomandibular disorders (TMD).
Methods: The study comprised 23 regularly menstruating women aged 20 to 45 with pain-related TMD. Twenty-four pain-free regularly menstruating women were recruited as controls. Two experimental pain procedures including application of electrical stimuli by electrical pulp tester and cold by refrigerant spray were performed on mandibular lateral incisors, in five menstrual phases (menstrual, follicular, periovulatory, luteal and premenstrual). TMD was assessed by Research Diagnostic Criteria for TMD. Repeated measures analysis of variance and Friedman test, with post-hoc Bonferroni correction were used to explore changes in experimental pain response over time.
Results: Women with TMD showed variability in pulp sensibility to both stimuli across the cycle. Post hoc comparisons showed the significant difference for cold stimulation, with higher pain sensitivity in menstrual in comparison to follicular (p=0.033), periovulatory (p=0.003) and luteal (p=0.007) phases. There were no intergroup differences in response to the applied stimuli.
Conclusions: Pulp sensitivity in women with TMD shows variation across the cycle for cold stimuli with peak in menstrual phase, but does not differ from pain-free controls.