Pain impact and psychological profiles of TMDs/Orofacial pain patients

Objective: To study the impact of pain and psychological aspects in new patients referred to an Orofacial pain/TMDs clinic. Methods: 122 patients who attended the Orofacial Pain/TMDs clinic at Faculty of Dentistry, Prince of Songkla University, between November 2003 to May 2005 were invited to complete the Thai version of Hospital Anxiety and Depression Scale (HADS) and Brief Pain Inventory (BPI) questionnaire. Pain history and physical examination data were collected using the Facial Pain Proforma. The RDC/TMD classification was used for the diagnosis of TMDs. Differences in psychological profile and impact of pain among the diagnostic groups, the pain severity were analysed with Kruskal-Wallis statistics. Results: Of the 122 patients, 98 were female and 24 were male (female to male ratio 4.1:1). 101 out of 122 patients completed the HADS and BPI. Of these 101 patients, 44 patients (44.4%) had anxiety (score ≥8) and 23 patients (23.2%) were depressed (score ≥8). Of the TMD group, the patients who have combined joint and muscle pain has more anxiety (15/31, 48.4%) and depression (10/30, 33.3%) than other groups of TMD. All the atypical facial pain (AFP) patients have both anxiety (3/3, 100%) and depression (2/3, 66.7%). The influence of pain on walking and relationship to others was significantly (p<0.05) different among diagnoses. Pain has no effect to eating ability of patients who have Atypical Facial Pain (med NRS=1) and Burning Mouth Syndrome (med NRS=1.5) which is contrast to the TMD group (med NRS=6, 5, 7) and Trigeminal Neuralgia (med NRS=9) patients. Mood disturbance and functional impairment measured by the BPI are significantly associated with the severity of pain (p<0.01). Conclusions: These results suggest that anxiety and depression is common in the chronic orofacial pain patients. The severity of pain affected to mood and impairment of function of BPI.