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The Effect of Fibromyalgia and Widespread Pain on the Clinically Significant Temporomandibular Muscle and Joint Pain Disorders—A Prospective 18-Month Cohort Study

  • Ana Miriam Velly
    Correspondence
    Address reprint requests to Ana M. Velly, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 7-546 Moos Tower, 515 Delaware St SE, Minneapolis, MN 55455.
    Affiliations
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota

    Faculty of Dentistry, McGill University, Montreal, Qc, Canada

    Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Qc, Canada
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  • John O. Look
    Affiliations
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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  • Eric Schiffman
    Affiliations
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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  • Patricia A. Lenton
    Affiliations
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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  • Wenjun Kang
    Affiliations
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota

    Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota
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  • Ronald P. Messner
    Affiliations
    Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Qc, Canada
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  • Christina A. Holcroft
    Affiliations
    Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Qc, Canada
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  • James R. Fricton
    Affiliations
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota

    Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota
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      Abstract

      Although most cases of temporomandibular muscle and joint disorders (TMJD) are mild and self-limiting, about 10% of TMJD patients develop severe disorders associated with chronic pain and disability. It has been suggested that fibromyalgia and widespread pain play a significant role in TMJD chronicity. This paper assessed the effects of fibromyalgia and widespread pain on clinically significant TMJD pain (GCPS II-IV). Four hundred eighty-five participants recruited from the Minneapolis/St. Paul area through media advertisements and local dentists received examinations and completed the Graded Chronic Pain Scale (GCPS) at baseline and at 18 months. Baseline widespread pain (OR: 2.53, P = .04) and depression (OR: 5.30, P = .005) were associated with onset of clinically significant pain (GCPS II-IV) within 18 months after baseline. The risk associated with baseline fibromyalgia was moderate, but not significant (OR: 2.74, P = .09). Persistence of clinically significant pain was related to fibromyalgia (OR: 2.48, P = .02) and depression (OR: 2.48, P = .02). These results indicate that these centrally generated pain conditions play a role in the onset and persistence of clinically significant TMJD.

      Perspective

      Fibromyalgia and widespread pain should receive important consideration when evaluating and developing a treatment plan for patients with TMJD.

      Key words

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