Abstract
Evidence suggests that the effect of cigarette smoking on chronic pain is stronger
in younger than older adults. This case-control study investigated whether age modified
an effect of smoking on temporomandibular disorder (TMD) in 299 females aged 18 to
60 years. It also investigated the extent to which this relationship was explained
by psychological profile, inflammatory response, and allergy. Cases were defined using
the Research Diagnostic Criteria for Temporomandibular Disorders based on clinical
examination. Psychological profile was evaluated using standardized instruments. Inflammatory
response was evaluated with 11 cytokines isolated in plasma. History of allergy conditions
was self-reported. Odds ratios (ORs) for the effect of smoking were calculated using
binary logistic regression. Stratified analyses and the likelihood ratio test examined
effect modification by smoking. Compared with nonsmokers, ever smokers aged <30 years
had higher odds of TMD (OR = 4.14, 95% CI: 1.57, 11.35) than older adults (OR = 1.23,
95% CI: .55, 2.78) (P (effect modification) = .038). Adjustment for psychological profile, cytokines, and
history of allergy-like conditions attenuated the effect by 45% to statistical nonsignificance.
The main finding was reproduced with secondary analyses of 2 nationally representative
surveys of adults conducted in the US and Australia.
Perspective
This study showed that smoking was associated with TMD risk in females, but only in
young adulthood. It replicated this finding in 2 nationally representative surveys
of females in the US and Australia. Findings may alert clinicians to recognize that
smoking is a concern for TMD in younger female patients.
Key words
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Article info
Publication history
Published online: October 28, 2011
Accepted:
August 1,
2011
Received in revised form:
June 23,
2011
Received:
May 3,
2011
Footnotes
Supported by NIH grants DE016558 (L.D., PI), NS045685 (W.M., PD), NIH/NCRR KL2 RR025746 (A.G.N.), and NIH/NINDS PO1 NS045685-061A (A.G.N., G.D.S., L.D., and W.M.).
Identification
Copyright
© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
