Somatization and treatments received by patients with painful TMD over an eight-year follow-up: A descriptive study

Abstract

Aim: Our study aims to retrospectively analyze treatments received by subjects diagnosed with painful TMDs and their association with somatization over 8 years. The second objective was to identify if high baseline somatization was a risk factor for subjects seeking irreversible dental/surgical treatments. Methods: This is a secondary analysis of the dataset collected during the RDC/TMD Validation project (baseline) and Impact study (follow up). At baseline, demographics, pain characteristics, diagnosis of painful TMDs, somatization scores were collected for analysis. At follow up, demographics and treatments received were collected. Chi square test and Spearman correlation analysis were done. Results: We identified 195 participants who fit into the inclusion criteria at baseline. Combination of myofascial pain and arthralgia (51.8%) was most prevalent, 45.6% of the participants had myofascial pain alone and only 2.6% had arthralgia alone. Among the participants, 47.7% reported normal somatization scores, 34.5% reported moderate somatization and 18.4% of the participants reported severe somatization. The average treatments received were 6.5 (± 6.4), with a median of 5. The maximum number treatments received among all the participants was 33. Of the total participants, 13.7% participants had not received any treatments for painful TMD, whereas 23% had explored over 10 of the treatment options. Severe somatization showed a statistically significant association with use of strong analgesics or “pain killers” (p- value = 0.038) and dental restorations or reconstruction (crowns, bridges) to improve the bite (p- value = 0.0002) and with soft diet, jaw exercise, and use of herbs and nutrition and physiotherapy- soft tissue manipulation (p – value < 0.05). There was no statistically significant association with moderate somatization with any individual treatments. There was a positive correlation between somatization scores and total number of treatments received but it was not statistically significant. Although all the grouped treatments showed a positive correlation with somatization, the correlation was only statistically significant for use of alternative and complementary medicine (p- value < 0.05). Conclusions: Somatization was not statistically associated with treatments received over 8 years. Severe somatization was associated with dental restorations or reconstructions to improve bite but not other types of irreversible treatments.