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Regional Clinical Dental Research Center


TEMPOROMANDIBULAR JOINT STUDIES

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Menstrual Cycle Effects on TMD Pain and Other Symptoms: Studies 2 AND 3


PI: Linda LeResche, Ph.D., Research Professor, Oral Medicine, School of Dentistry, University of Washington

Temporomandibular disorders are musculoskeletal pain conditions characterized by pain in the temporomandibular joint and/or the muscles of mastication. TMD pain is a common pain problem, affecting approximately 7-15% of the adult population in North America. The highest prevalence for TMD conditions is among women in their reproductive years. TMD pain is 1.5-2 times more prevalent in women than in men in the community, and 80% of treated cases of TMD are women. Moreover, women are at significantly greater risk than men of experiencing disability due to TMD. This disability is associated with depression, significant use of health services and increased use of opioid and sedative hypnotic medications. In addition, treatment of TMD can be associated with severe iatrogenic consequences. Because of their high prevalence and potential for adverse consequences, these conditions represent important health problems for women.

We propose to investigate a number of hypotheses related to the female predominance of TMD pain. These hypotheses are based on a dynamic ecologic model of chronic pain and involve the interaction of biologic, psychologic and social factors. We propose to test hypotheses related to the possible interactive influences of: reproductive hormones, gender factors in pain perception, psychological distress, and the presence of other physical symptoms both in the reproductive system and elsewhere in the body on levels and temporal patterning of pain in female TMD patients and appropriate control groups.

The overall objective of this project is to assess whether cyclic changes in levels of endogenous reproductive hormones are related to levels of pain in female TMD patients. Specifically we will assess variability in responses to standardized experimental pain stimuli at critical points (menses, ovulation, mid-luteal phase and late luteal/premenstrual phase) across three consecutive ovulatory cycles in female TMD cases and control subjects. Thus, the proposed studies will illuminate relationships between clinical pain, generalized pain sensitivity, psychological state, gender and hormonal status. Data collection for this project will begin in June, 1999



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