Drangsholt, Mark TMishra, Rashmi2020-02-042020-02-042020-02-042019Mishra_washington_0250O_20844.pdfhttp://hdl.handle.net/1773/45167Thesis (Master's)--University of Washington, 2019Background: Temporomandibular disorder (TMD) is a common pain condition experienced mainly by young and middle-aged women. Depression, multiple pain conditions, and gender, along with bruxism, exogenous hormones, trauma, and hypermobility, appear to be associated with risk factors. The change in the proportion of persons complaining of TMD pain and seeking care over the last few decades is not known. TMD diagnostic systems that are reliable, accurate, and predictive are currently available, but the uncoordinated use of four or five different systems may have stymied research efforts. The TMD prevalence at the population level is still a matter of debate, owing to the heterogeneity in the diagnostic criteria adopted in different investigations. Therefore, this review aims to summarize relevant findings and trends related to TMD pain according to different diagnostic systems and provide a summary of the global prevalence and incidence of TMD pain. This project will be the first step towards calculating the global burden for TMD pain, which, in turn, would be helpful in prevention and policies for the future. This has not been performed in a systematic way to date, but insights from recent rounds of the Global Burden of Disease study in relation to other common pain conditions such as low back pain and neck pain provide pointers to the steps that need to be taken to achieve this goal. Aim: To summarize and systematically review the peer-reviewed literature on the TMD pain prevalence and incidence reported in studies adopting different diagnostic systems. Methods: Papers were identified through a systematic search and review process. RDC/TMD Axis I criteria were considered as the reference definition for TMD pain. Studies that used other standards or interpretations that reported and or verified pain in the muscles of mastication and/or jaw pain were included. The studies included those in which TMD was diagnosed by a trained examiner or identified through questionnaires (either self-administered or by research staff). One senior graduate student in oral medicine (Ishraq Alshanqiti) was trained to assess the data and do the screening of articles based on inclusion criteria after reaching interrater reliability of kappa=0.8 (between R.M. and I.A.). Differences among the two reviewers were resolved by discussion, rereading, and consultation with the orofacial pain expert (M.D.) when necessary. The following data/information was recorded from each of the selected papers by R.M., with input from M.D., for analysis and discussion: sample size and demographic features (age, sex, population); prevalence of TMD pain, incidence of TMD pain, the diagnostic system utilized. Results: Seventy-five (n =75) papers were included in the review, 67 dealing with prevalence on TMD pain and eight on the incidence of TMD pain. The most common diagnostic system used was RDC/TMD. Prevalence reports were highly variable across studies, even among those using the same diagnostic system. For children, the range of prevalence of TMD pain was 0.2% to 28%. In general, pain in the temporomandibular joint (TMJ) varied from 0.7% to 4%, depending upon the age. For adults, general prevalence estimates ranged from 2% to 8% for males and 4% to 15% for females. Myofascial pain was the most frequent diagnosis in TMD pain. The incidence of TMD pain was reported in a narrow range from 2.0% to 4.5% per year. Conclusions: Although the range of prevalence was wide, TMD pain was shown to be a common pain condition in both children and adults. Descriptive epidemiologic studies of TMD pain can be enhanced by following the usual methods in epidemiologic research, such as reporting age and gender-specific prevalence and establishing standardized self-report definitions.application/pdfen-USnoneGBDIncidencePrevalenceTMDDentistryDentistryThesis