Orofacial pain and its relationship with oral health-related quality of life and psychological distress in middle-aged women

Figures & data

Table 1. Formulation of the questions in the questionnaire.

Question about symptoms during the last month

1 Do you have pain in your jaw when you chew?

2 Do you have pain in your face in front of the ear?

3 Do you have pain in your jaw when you open wide?

4 Do you have headaches?

5 Are your jaws and muscles tired/tender/stiff when waking up or moving the lower jaw?

Table 2. The number of invited and participating women, aged 38 and 50 years, at the examinations in 2004 and 2016, together with marital status and educational level.

	38 years old, examination 2004 Born 1966 n	38 years old, examination 2016 Born 1978 n	50 years old, examination 2004 Born 1954 n	50 years old, examination 2016 Born 1966 n	Total n
Invited	343	415	503	430	1766
Participants	207 (60.3%)	263 (63.4%)	293 (58.2%)	310 (72.1%)	1073 (60.8%)
Included in study	201	263	286	309	1059
Living with a partner, n(%)^a	89 (45.2)	128 (49.6)	151 (52.8)	143 (46.4)	509 (48.8)
Education, n(%)^1
Low	5 (2.5)	3 (1.2)	34 (11.9)	9 (2.9)	51 (5.6)
Medium	82 (41.6)	64 (24.8)	109 (38.1)	113 (36.7)	367 (35.1)
High	110 (55.8)	187 (72.5)	143 (50.0)	186 (60.4)	626 (60.0)

^a Information about demographics is based on total n = 1044.

Table 3. The distribution of subjective symptoms of TMD-related pain and headache in four cohorts of middle-aged women.

	38 years old 2004	38 years old 2016	50 years old 2004	50 years old 2016	Total
	201	263	286	309	1059
Participants (n)	n, % (95%CI)	n, % (95%CI)	n, % (95%CI)	n, % (95%CI)	n, % (95%CI)
Severe TMD-pain^a positive to one or more of three questions (pain when chewing/in front of ear/open wide)	3, 1.5% (0.6–2.4)	6, 2.3% (1.4–3.2)	7, 2.4% (1.5–3.3)	19, 6.1% (4.7–7.5)	35, 3.3% (2.8–3.8)
Severe headache^a	32, 15.9% (13.3–18.5)	29, 11.0% (9.1–12.9)	36, 12.6% (10.6–14.6)	25, 8.1% (6.5–9.7)	122, 11.5% (10.5–12.5)
Severe headache^a with concomitant TMD symptoms^b	12, 6.0% (4.3–7.6)	14, 5.3% (3.9–6.7)	13, 4.5% (3.3–5.8)	14, 4.5% (3.3–5.7)	53, 5.0% (4.3–5.7)
Severe orofacial pain^c	14, 7.0% (5.2–8.8)	20, 7.6% (6.0–9.3)	20, 7.0% (5.4–8.4)	28, 9.1% (7.5–10.8)	82, 7.7% (6.9–8.6)

^a Positive to pain question and meeting the inclusion criteria; chronic pain >1 month, intensity ≥40 on an NRS scale 0-100, frequency  > once a week.

^b Positive to question about tired/stiff/tender jaw and/or positive to TMD pain question (regardless of severity).

^c Severe TMD pain positive or positive for severe headache with concomitant TMD symptoms. The women included in both groups are only counted once.

Table 4. The distribution of mean scores for anxiety and depression from the HADS, SOC-13 and OHIP-5 in the total, non-case and severe orofacial pain group.

	Total group	Non-case group	Orofacial pain group	Group mean difference	p-value	Effect size
Participants (n)	1059	977	82
Anxiety
HADS-A	5.1 (3.8) 5.0	4.9 (3.6) 4.0	8.1 (4.6) 8.0	3.2 (2.2–4.3)	<.001	0.38
Depression
HADS-D	3.1 (2.9) 2.0	2.9 (2.7) 2.0	5.8 (4.2) 6.0	2.8 (1.9–3.8)	<.001	0.39
SOC-13	69.9 (12.1) 72	70.8 (11.4) 73	59.2 (14.2) 59.5	11.6 (8.4–14.8)	<.001	0.45
OHIP-5	2.2 (2.5) 1.0	2.0 (2.3) 1.0	4.5 (3.8) 4.0	2.5 (1.7– 3.4)	<.001	0.46

Values are given as: mean, (SD), median. In the column “Group mean difference” 95% CI is given.

Figure 1. Proportions of signs of anxiety (HADS-A, score ≥8), signs of depression (HADS-D, score ≥8) and poor OHRQoL (score three or four on more than two items in the OHIP-5) in a group of 1059 middle-aged Swedish women.

Table 5. Multivariable logistic regression analysis of factors related to the dependent variable severe orofacial pain in a cross-sectional female representative cohort.

		Odds ratio	95% CI	Regression coefficient	Standard error	p-value
Signs of anxiety	HADS <8	1.0
HADS-A	HADS ≥8	1.1	0.6–2.1	0.19	0.3	.75
Signs of depression	HADS <8	1.0
HADS-D	HADS ≥8	2.1	1.1–4.3	0.12	0.4	.03
SOC-13 score		0.96	0.94–0.99	−0.39	0.01	.003
OHIP-5 score		1.2	1.1–1.3	0.19	0.04	<.001
Age	38 years	1.0
	50 years	1.2	0.7–2.0	0.19	0.3	.45
Examination year	2004	1.0
	2016	1.1	0.7–1.9	0.12	0.3	.65
Marital status	Single	1.0
	With partner	1.6	0.9–2.6	0.44	0.3	.08
Educational level	High	1.0				.48
	Medium	0.5	0.2–1.7	−0.66	0.6	.27
	Low	1.1	0.6–1.8	0.72	0.3	.79

Model with the dichotomous, categorical variables of anxiety and depression. The values of SOC-13 and OHIP-5 are continuous while age, examination year, marital status and education level are other independent ordinal categorical variables.

Bold values highlight the significant associations.