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Post-Traumatic Stress Disorder in a Military Population with Temporomandibular Disorder
Introduction: Post-traumatic stress disorder (PTSD) occurs following exposure to a stressor or emotional trauma. It frequently co-occurs with chronic pain conditions, to include temporomandibular disorders (TMD). Objectives: To assess the prevalence of PTSD in patients with TMD and to explore its association to psychosocial factors. Methods: This ongoing study collected information from the initial examination of 150 new patients at the Orofacial Pain Center, Naval Postgraduate Dental School. Patient demographics, pain characteristics, psychosocial factors, and primary TMD diagnosis were compared based on PTSD status. Associations of demographics, PTSD status, and TMD diagnosis with pain intensity was evaluated using linear regression. Mediation analyses were completed to explore impact of psychosocial factors on the relationship between PTSD status and pain intensity. Results: PTSD prevalence was 19 percent. Patients positive for PTSD reported more symptoms of anxiety, depression, sleep disturbance, and more intense pain severity compared to patients not meeting PTSD criteria (all ps less than 005). Patients diagnosed with masticatory muscle pain were more likely to have significant symptoms of PTSD compared to TMJ pain patients. Conclusions: This study highlights the need for dentists to screen for the presence of PTSD symptoms in patients with TMD and understand how these symptoms can adversely affect management of TMD. This study showcases how anxiety, depression, and insomnia each can influence the relationship between PTSD and TMD.
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