Research Information System University of Greifswald

Kindler S*¹, Mksoud M¹, Schwahn C², Bernhardt O³, Söhnel A², Biffar R², Meyer G, Völzke H⁴, Metelmann H¹, Grabe H⁵

1 - Zentrum für Zahn-, Mund- und Kieferheilkunde / Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie/Plastische Operationen

2 - Zentrum für Zahn-, Mund- und Kieferheilkunde / Poliklinik für Zahnärztliche Prothetik, Alterszahnheilkunde und Medizinische Werkstoffkunde

3 - Zentrum für Zahn-, Mund- und Kieferheilkunde / Poliklinik für Zahnerhaltung,Parodontologie, Endodontologie; Präventive Zahnmedizin und Kinderzahnheilkunde

4 - Institut für Community Medicine / Abt. SHIP KEF

5 - Klinik und Poliklinik für Psychiatrie und Psychotherapie

AIMS: To estimate the association between signs of temporomandibular disorders (TMD) and symptoms of posttraumatic stress disorder (PTSD) in a representative sample from the general population of northeastern Germany. METHODS: Signs of TMD were assessed with a clinical functional analysis that included palpation of the temporomandibular joints (TMJs) and masticatory muscles. PTSD was assessed with the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, ed 4. The change-in-estimate method for binary logistic regression models was used to determine the final model and control for confounders. RESULTS: After the exclusion of subjects without prior traumatic events, the sample for joint pain consisted of 1,673 participants with a median age of 58.9 years (interquartile range 24.8), and the sample for muscle pain consisted of 1,689 participants with a median age of 59.1 years (interquartile range 24.8). Of these samples, 84 participants had pain on palpation of the TMJ, and 42 participants had pain on palpation of the masticatory muscles. Subjects having clinical PTSD (n = 62) had a 2.56-fold increase in joint pain (odds ratio [OR] = 2.56; 95% confidence interval [CI]: 1.14 to 5.71, P = .022) and a 3.86-fold increase (OR = 3.86; 95% CI: 1.51 to 9.85, P = .005) in muscle pain compared to subjects having no clinical PTSD. CONCLUSION: These results should encourage general practitioners and dentists to acknowledge the role of PTSD and traumatic events in the diagnosis and therapy of TMD, especially in a period of international migration and military foreign assignments.