The Association Between the Central Sensitisation Inventory and Temporomandibular Disorders Is Confounded by Migraine, Depression, Widespread Pain and Parafunction. A Cross‐Sectional Telehealth Study

• Published in: Journal of oral rehabilitation Vol. 51; no. 12; pp. 2577 - 2587
• Main Authors: Calixtre, Letícia Bojikian, Meer, Hedwig Aleida, Visscher, Corine Mirjam, Oliveira, Ana Beatriz, Godoi Gonçalves, Daniela Aparecida
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-12-2024
• Subjects: Anxiety disorders; central sensitisation; Headache; Jaw; Mastication; Mental depression; Migraine; Muscles; orofacial pain; Pain; primary headache disorders; Psychological aspects; Questionnaires; telehealth; Telemedicine; Temporomandibular joint; Temporomandibular joint disorders; widespread chronic pain; orofacial pain; central sensitisation; primary headache disorders; widespread chronic pain; telehealth
• ISSN: 0305-182X; 1365-2842; 1365-2842
• DOI: 10.1111/joor.13852

ABSTRACT
Background
Temporomandibular disorders (TMDs) are conditions that involve the temporomandibular joints, masticatory muscles, and associated tissues, causing orofacial pain. Central sensitisation (CS) is a relevant part of the TMD pathophysiology. Migraine, psychological aspects, parafunctional oral habits and widespread pain are commonly associated with both TMD and CS and could confound the association between them.
Objectives
To investigate the association between painful TMD and the Central Sensitisation Inventory (CSI) score, and to assess the presence of confounders in this association.
Methods
Cross‐sectional study that assessed women with and without orofacial pain complaints using telehealth. The TMD Pain Screener and an online physical examination determined the presence of painful TMD. The following questionnaires were applied: CSI, Headache Screening Questionnaire, Generalized Anxiety Disorder‐7, Patient Health Questionnaire‐9, Oral Behavior Checklist, Jaw Functional Limitation Scale and the Nordic musculoskeletal questionnaire. A single regression investigated the association between the CSI score and TMD, and a multiple regression investigated the effect of the other outcomes as possible confounders. Confounding was considered present when the association between TMD and the CSI score changed more than 10% after adding a possible confounder to the regression model.
Results
Forty‐two women with painful TMD and 53 without TMD were included. There was a significant association between the CSI score and the presence of painful TMD (R2 = 0.639; p < 0.001). This association changed when the following outcomes were added to the model: presence of migraine, symptoms of depression, widespread pain and parafunctional oral habits.
Conclusion
The positive association between TMD and the CSI score was confounded by migraine, symptoms of depression, widespread pain and parafunctional oral habits.
There is a significant association between the CSI score and the presence of painful TMD, which was confounded by the presence of migraine, anxiety, depression, widespread pain, and parafunctional oral habits. The total or the corrected CSI scores did not influence this result.