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This study assessed the prevalence of Temporomandibular Joint (TMJ) Dysfunction in students at Tufts University of Dental Medicine. Three classes were administered in a 12 item questionnaire requiring a yes/no response to questions about discomfort and dysfunction of the TMJ and associated muscles. Of 125 forms administered, Class of 1990 ('98) returned 105 (mean age 26.8), Class of 1999 ('99) 115 (mean age=25.1) and Class of 2000 ('00) 100 (mean age of 23.7) Each class had a ratio of approximately 60 males to 40 females. The number responding to at least one item was 65 for '98, 76 for '99 and 45 for '00. There was no difference in sex response. Generalized chi square showed a significant difference in the responses of the three classes. Seperate Teates corrected 2x2 chi squared tests showed that the number responding in '98 was no different from '99 while the number responding in both '98 and '99 were significantly larger than in '00. Because of this the results of '00 could not be pooled with those of '98 and '99. Of 220 students, 43% reported clenching and grinding, 30% reported noises in the joint, 21% sore muscles of mastication, 13% frequent headaches, 11% difficulty and/or pain chewing or talking. 10% jaw "locking or going out" and 7% difficulty and/or pain on opening. Students who answered at least one of the 12 questions were requested to rate pain/discomfort on 11, 10-point Visual Analogue Scales (VAS) each locating a pain site. Of the 220 students, 24% responded to TMJ by clicking (mean VAS=4.3), 18.9% to neck pain (mean VAS=4.2), 16.9% to headaches (mean VAS=4.7), 13.8% to TMJ pain (mean VAS=4.2), 16.9% to headaches (mean VAS=4.7), 13.8% to TMJ pain (mean VAS=3.7), 13.3% to pain in teeth (mean VAS=3.2), 8.9% to face pain (mean VAS=3.6). The prevalence of symptoms is osmewhat higher than repoprted in Swedish dental students and young men of comparable age. The observations in this, the first of a series of students to track symptoms over each year of dental school, suggest that dental schools screen students for TM Dysfunction.

This stidy was designed to assess the change in psychological variables following biteplate therapy in the treatment of Temporomandibular Dysfunction. The SCL-90 (Derogatis) is a self-report test which assesses 9 psychological dimensions. Thirty-one patients of the Gelb Craniomandibular/Orofacial Pain Center were selected at random from 150 patients treated in a six month period. The SCL-90 along with a 10-point Visual Analogue scale to measure pain were administered before treatment and at the end of treatment (6 months after treatment began). Then 6 months later, the inventories were mailed to the patients. Eighteen responded to the 6-month follow up. Their responses were analyzed with Wilcoxon Signed Rank Tests (WSRT). General pain decreased significantly from initial levels over the first 6 months ( and 6 months later the decrease was maintained. The pain levels of the two periods were no different. Two psychological dimensions showed significant reductions over teh assessment periods. Although depression did not show a significant reduction six months after treatment began. It did decrease a significant degree from pre-treatment level by the one year period. Likewise, hostility did not decrease significantly by 6 months after start of treatment, but did reduce to a significant level by one year following initiation of treatment. None of the other psychological dimensions showed significant changes for the periods assessed. The results indicate that a significant reduction in pain results from biteplate therapy after 6 months of treatment and this reduction from pre-treatment level persists six months after termination of treatment. The appearance of significant reductions in depression and hostility 6 months after termination argues for follow-up testing because impact on psychological dimensions may not become manifest until some time after treatment is terminated.

The aim of this study was to determine the effect of pain reduction on the quality of life in pain patients. The Visual Analogue Scale (VAS) was used to measure specific pain itmes (earache, TMJ pain, Headaches, neck, upper and lower back pain), whereas the Short Form 36 (SF-36)was used to measure the quality of life through its 8 items: Physical Functiong(PF), Role Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (PF), Role Emotional (RE) and Mental Health(MH). Fourty-four TMD and Orofacial pain patients (F=36, M=8, AGE= 35+/-13) with no history of physical disabilty of psychological problems were selected. Thirty control subjects (F=14,M=16, AGE=35+/-10) were selected randomly from the faculty and staff at the university. Patients and controls were requested to complete the VAS and the SF-36 forms at the initiation of the study and 3 months later. All patients had conservative treatment using intraoral appliance therapy with/out physical therapy modalities for the period of the study. The Wilcokon signed rank test was used to compare between pre and post treatment pain and SF-36 for patients and controls. There was a significant reduction in all pain items for patients, whereas there were no statistically significant changes for controls. SF-36 results showed a significant increase in all items fro patients with the exception of GH and RE. There were no significant changes in any of the SF-36 items for controls except an increase in social functioning. The Spearman's rhe was used to determine pre and post-treatment correlations between pain and SF-36 items. There were significant pre-treatment as well as post-treatment correlations for 1) TMJ pain and PF, RP, 2) face pain and VT, MH, 3) u/back and all SF-36 items except RE, 4) l/back and PF, VT. These results indicate that the reduction of pain in TMD and orofacial pain patients is associated with an improvement in patient's well-being, quality of life and perception of health as measured by the SF-36.