Associations between pain-related temporomandibular disorders and dental anxiety at 46 years of age in the Northern Finland Birth Cohort 1966

Abstract

Objectives

The aims were (1) to study the association between dental anxiety (DA) and temporomandibular disorders (TMDs) and whether subgroups formed differ in psychological symptoms and pain sensitivity in the Northern Finland Birth Cohort 1966 and (2) to confirm the factor structure of the Hopkins Symptom Checklist-25 assessing psychological symptoms.

Materials and methods

Data were acquired using questionnaires and clinical examinations at age 46 years (n = 1889). Dental anxiety was assessed with Modified Dental Anxiety Scale (MDAS). Pain-related TMD (myalgia, arthralgia) were assessed according to modified diagnostic criteria for temporomandibular disorders. Pressure pain threshold and tolerance were measured with an algometer. Explanatory factor analysis revealed three factors, named ‘depression’, ‘anxiety’ and ‘distress’.

Results

Those with high DA and myalgia and/or arthralgia reported higher depression (mean = 1.52), anxiety (mean = 1.61) and distress (mean = 2.06) scores, and lower pressure pain threshold (mean = 496 kPa) and tolerance (mean = 741 kPa) values than those with only DA (1.22; 1.56; 1.84; 613; 875), TMD (1.21; 1.39; 1.83; 600; 908) or neither (1.12; 1.29; 1.58; 707; 1006), respectively.

Conclusions

Patients with DA and/or myalgia/arthralgia have similar profiles regarding pain sensitivity and psychological symptoms, the burden being highest among those with DA and a TMD diagnosis.

Keywords:

• Chronic pain
• dental fear
• myalgia
• arthralgia
• pain threshold

Acknowledgements

We thank the late professor Paula Rantakallio (launch of NFBC1966), the participants in the 46-year study and the NFBC project center. We would also like to acknowledge the Infrastructure for Population Studies at the Medical Faculty, University of Oulu, and the examiners behind the clinical stomatognathic examinations and pressure pain measurements at the Medical Faculty, University of Oulu.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

NFBC1966 received financial support from University of Oulu under Grant No. 24000692, Oulu University Hospital under Grant No. 24301140 and ERDF European Regional Development Fund under Grant No. 539/2010 A31592.