The Prevalence of Tooth Wear in the Dutch Adult Population

This study aimed to assess the prevalence of tooth wear in different age groups of the Dutch adult population and to determine this tooth wear distribution by gender, socioeconomic class, and type of teeth. Results were compared with the outcomes of a previous study in a comparable population. As part of a comprehensive investigation of the oral health of the general Dutch adult population in 2013, tooth wear was assessed among 1,125 subjects in the city of 's-Hertogenbosch. The data collected were subjected to stratified analysis by 5 age groups (25-34, 35-44, 45-54, 55-64, and 65-74 years), gender, socioeconomic class, and type of teeth. Tooth wear was assessed using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected was higher in older age groups. Men showed more tooth wear than women, and subjects with low socioeconomic status (low SES) showed on average higher scores than those with high SES. Tooth wear prevalence found in this study was higher in all age groups than in the previous study. The present study found prevalences of 13% for mild tooth wear and 80% for moderate tooth wear, leading to the conclusion that these are common conditions in the Dutch adult population. Severe tooth wear (prevalence 6%) may however be characterized as rare. A tendency was found for there to be more tooth wear in older age groups, in men as compared with women, in persons with lower SES, and in the present survey as compared with the previous one

Comprehension of pictograms for pain quality and pain affect in adults with Down syndrome

Background Adults with Down syndrome (DS) are at risk for age-related painful physical conditions, but also for under-reporting pain. Pictograms may facilitate self-report of pain, because they seem suitable for the global visual processing in DS and for iconic representation of abstract concepts. Method Participants (N = 39, M age = 41.2) assigned pain qualities to pictograms, rated pain affect levels in facial scales (pictograms vs. drawn faces), and performed cognitive tests. Results Recognition of all intended pain qualities was above chance level. Pain affect levels of both facial scales were ordered equally well. Both facial scales were preferred equally we

Team players against headache: multidisciplinary treatment of primary headaches and medication overuse headache

Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform for more intense collaboration between these professions and between headache centers is needed. Our aims were to establish closer collaboration and an interchange of knowledge between headache care providers and different disciplines. A scientific session focusing on multidisciplinary headache management was organised at The European Headache and Migraine Trust International Congress (EHMTIC) 2010 in Nice. A summary of the contributions and the discussion is presented. It was concluded that effective multidisciplinary headache treatment can reduce headache frequency and burden of disease, as well as the risk for medication overuse headache. The significant value of physiotherapy, education in headache schools, and implementation of strategies of cognitive behavioural therapy was highlighted and the way paved for future studies and international collaboration

Impact of Catastrophizing in Patients with Temporomandibular Disorders: A Systematic Review

Aims: To assess the prevalence of catastrophizing in patients with temporomandibular disorders (TMD) and the possible associations between catastrophizing and treatment outcome. Methods: This review was registered in the Prospero database (CRD42018114233). Electronic searches were performed in PubMed, Scopus, and PsycINFO from the inception of each database up to October 26, 2018, and were combined with a hand search. Articles focusing on levels of catastrophizing and how catastrophizing affects pain levels and treatment outcomes for patients diagnosed with TMD were included, as well as studies reporting how treatment outcomes were affected by cognitive behavioral treatment as an addition to standard treatment for TMD. Reviews and case reports were excluded. Risk of bias was assessed with the Newcastle-Ottawa scale. Results: The literature search identified 266 articles. After screening of abstracts, the full texts of 59 articles were assessed. Of these, 37 articles, including 4,789 patients with TMD and 6,617 controls, met the inclusion criteria. Higher levels of pain catastrophizing were reported in patients with TMD, with a large effect size (Hedges’ g = 0.86) compared to pain-free controls. Furthermore, associations of higher levels of catastrophizing with higher symptom severity and with poorer treatment outcome were reported together with indications of positive effects from cognitive behavioral therapy. Conclusion: The results suggest an association between catastrophizing and TMD that may affect not only symptom severity but also treatment outcome. Assessing levels of pain catastrophizing might therefore be valuable in the assessment and management of patients with TMD. J Oral Facial Pain Headache 2020;34:379–397. doi: 10.11607/ofph.263

The effect of singing on pain and psychological well-being in a patient population with pain-related temporomandibular disorders

Background: Even though singing is regarded as potential jaw-overuse behaviour, the actual evidence that underlines the idea of singing as a predisposing factor for pain-related temporomandibular disorders (TMD) is very limited. Objectives: The objectives were to examine if a dose–response relationship exists between the frequency of singing and TMD pain intensity, and if singing is associated with psychological well-being. Methods: The records of 1467 adult patients with functionally aggravated TMD pain were examined. Partial Spearman correlations were used to explore for associations between singing frequency and Characteristic Pain Intensity (CPI), somatic symptoms, depression and anxiety. Results: The mean age of all participants was 42.8 years (±15.3), of which 79.2% were female. Contrary to the male–female ratio, no difference was found in the mean age between the response options with regard to the frequency of singing. Controlled for the influence of gender, the Spearman correlation between the frequency of singing and CPI appeared to be significant and indicated a negative association. In addition, somatic symptoms appeared to be positively associated with the frequency of singing. However, the observed correlation coefficients (ρ = −.073 and ρ =.067, respectively) imply that these are only very weak or negligible correlations. No significant associations with the frequency of singing were found for depression and anxiety. Conclusions: The alleged negative influence of singing on TMD pain intensity was found to be virtually absent. Patients with TMD pain who sing frequently have almost equal scores on psychological well-being compared to those who sing less

The change in self-efficacy of novice dentists in Endodontics within the first year following graduation from Aarhus University or the Academic Centre for Dentistry Amsterdam

Aim: To understand whether the self-efficacy of novice dentists in Endodontics changes within the first year following their graduation, and to reveal factors related to a possible change. Methodology: Data were obtained from dental graduates from Aarhus University, Denmark or from the Academic Centre for Dentistry Amsterdam, the Netherlands. The 60 participants filled out the Endodontic General Self-Efficacy Scale questionnaire close to their graduation (baseline) and 1 year following their graduation (follow-up). Additionally, data on their experience in Endodontics within the first year following graduation were gathered, as well as data on their work environment, their referral behaviour and the postgraduation education they attended. For comparisons, chi-square tests, Fisher's exact tests, Mann-Whitney tests, and t-tests were used. Referral behaviour and the change in self-efficacy were studied by multiple regression analyses. Results: Most participants showed an increase in self-efficacy after graduation. The increase in self-efficacy was higher for those whose baseline self-efficacy was lower, and lower for those whose baseline self-efficacy was higher. Self-efficacy increased with experience in performing root canal treatments within the first year following graduation. Participants with higher average self-efficacy (i.e. mean of baseline and follow-up self-efficacy) referred patients for endodontic surgery more often than participants with lower average self-efficacy did. Conclusions: The self-efficacy of novice dentists in Endodontics generally increased within the first year following their graduation. The increase in self-efficacy was greater for those who had low self-efficacy at graduation than for those who already had high self-efficacy. Performing root canal treatments was an important factor in increasing self-efficacy

The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia

OBJECTIVE: Pain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis. METHODS: A study population (n = 300), randomly selected from the adult population in Vasterbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome. RESULTS: Positive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3-9.9). This association was confounded by concurrent myalgia (B = 1.737 --> B = 0.996, 42.7%). CONCLUSION: In a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia. CLINICAL RELEVANCE: Concurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable

Validity of three screening questions (3Q/TMD) in relation to the DC/TMD

Temporomandibular disorders (TMD) are common but seem to be largely undetected within general dental care. To improve dentists' awareness of these symptoms, three screening questions (3Q/TMD) have been introduced. Our aim was to validate 3Q/TMD in relation to the diagnostic criteria for TMD (DC/TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20-69 years old, who had their routine dental check-up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q-positives (at least one affirmative) were invited for examination in randomised order. For each 3Q-positive, a matched 3Q-negative was invited. In total, 152 3Q-positives and 148 3Q-negatives participated. At examination, participants answered 3Q/TMD a second time, before they were examined and diagnosed according to DC/TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale-20 (JFLS-20) were used. In total, 74% of 3Q-positives and 16% of 3Q-negatives met the criteria for DC/TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty-five per cent of 3Q-positives had a TMD diagnosis and CPI score ≥3 or a JFLS-20 score ≥5, compared to 4% of 3Q-negatives. The results show that the 3Q/TMD is an applicable, cost-effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management