Frequência de cefaleia em trabalhadores de uma empresa de borracha no Estado de São Paulo, Brasil

CONTEXT AND OBJECTIVE: Primary headaches may be responsible for absenteeism and a fall in the yield and productivity of work. The aim of this study was to establish the presence and frequency of primary headache among employees of a rubber shoe sole company, and its link to absenteism. DESIGN AND SETTING: Cross-sectional study carried out with help from the staff of the medical and social department of a rubber factory located in the municipality of Franca, São Paulo. METHOD: A questionnaire on headache characteristics was distributed to all employees. The returned and completed questionnaires were divided into two groups: with and without reports of headache. The headaches were classified into four main groups: migraine, tension-type headache (TTH), cluster headache and others. In terms of the reported frequency, headaches were also classified as chronic daily headache (CDH). RESULTS: The number of valid questionnaires was 392 (59%); 80.9% were from male and 19.1% from female employees. Headaches were reported by 120 subjects (30.6%), with 17.4% belonging to the migraine group and 8.9% to the TTH group. Migraine was more frequent (p < 0.001) among all participants and also among the women (p < 0.05). TTH was more frequent among the men (p < 0.05). CDH was identified in 14 individuals (3.6%). CONCLUSIONS: Headache was a common problem among the employees of this company and was a cause of absenteeism for 8.7% of the respondents to the questionnaire.CONTEXTO E OBJETIVO: Cefaleias primárias podem ser causa de absenteísmo, e de queda no rendimento e na produtividade do trabalho. O objetivo do estudo foi estabelecer a presença e frequência de cefaleia primária em funcionários de uma empresa de solados de borracha,e sua relação com absenteísmo. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado com a ajuda do pessoal do departamento médico e social de uma empresa localizada no município de Franca, São Paulo. MÉTODO: Um questionário sobre as características da cefaleia foi distribuído a todos os funcionários. Os questionários devolvidos e preenchidos foram divididos em dois grupos: com e sem relato de cefaleia. As cefaleias foram classificadas em quatro grupos principais: migrânea, cefaleia do tipo tensional (CTT), cefaleia em salvas e outras cefaleias. Através da frequência da cefaleia, foi possível a classificação em cefaleia crônica diária (CCD). RESULTADOS: O número de questionários válidos foi de 392 (59%), 80,9% questionários eram de funcionários do gênero masculino, e 19,1%, do gênero feminino. Cento e vinte (30,6%) dos funcionários relataram apresentar cefaleia, sendo que 17,4% pertenceram ao grupo migrânea e 8,93% ao grupo CTT. O diagnóstico de migrânea foi o mais frequente (p < 0,001) dentre todos, e também entre as mulheres (p < 0,05). O diagnóstico de CTT foi mais frequente entre os homens (p < 0,05). CCD foi identificada em 14 indivíduos (3,6%). CONCLUSÕES: Cefaleia é um problema frequente entre os funcionários da empresa participante da pesquisa sendo a causa de absentismo em 8,7% dos que responderam o questionário

How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders?

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Management of painful temporomandibular joint clicking with different intraoral devices and counseling: a controlled study

Objective The benefit of the use of some intraoral devices in arthrogenous temporomandibular disorders (TMD) patients is still unknown. This study assessed the effectiveness of the partial use of intraoral devices and counseling in the management of patients with disc displacement with reduction (DDWR) and arthralgia.Materials and Methods A total of 60 DDWR and arthralgia patients were randomly divided into three groups: group I (n=20) wore anterior repositioning occlusal splints (ARS); group II (n=20) wore the Nociceptive Trigeminal Inhibition Clenching Suppression System devices (NTI-tss); and group III (n=20) only received counseling for behavioral changes and self-care (the control group). The first two groups also received counseling. Follow-ups were performed after 2 weeks, 6 weeks and 3 months. In these sessions, patients were evaluated by means of a visual analogue scale, pressure pain threshold (PPT) of the temporomandibular joint (TMJ), maximum range of motion and TMJ sounds. Possible adverse effects were also recorded, such as discomfort while using the device and occlusal changes. The results were analyzed with ANOVA, Tukey’s and Fisher Exact Test, with a significance level of 5%.Results Groups I and II showed improvement in pain intensity at the first follow-up. This progress was recorded only after 3 months in Group III. Group II showed an increased in joint sounds frequency. The PPT values, mandibular range of motion and the number of occlusal contacts did not change significantly.Conclusion The simultaneous use of intraoral devices (partial time) plus behavioral modifications seems to produce a more rapid pain improvement in patients with painful DDWR. The use of NTI-tss could increase TMJ sounds. Although intraoral devices with additional counseling should be considered for the management of painful DDWR, dentists should be aware of the possible side effects of the intraoral device’s design

Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

Dentists are exposed to contamination by SARS-CoV-2 due to dental interventions, leading to a state of alert and potential risk of negative impact in mental health and sleep quality, associated with Temporomandibular Disorder (TMD) and bruxism.&nbsp;Objective: to evaluate the psychosocial status, sleep quality, symptoms of TMD, and bruxism in Brazilian dentists (DSs) during the COVID-19 pandemic. Methodology: The sample (n=641 DSs) was divided into three groups (quarantined DSs; DSs in outpatient care; and frontline professionals), which answered an electronic form containing the TMD Pain Screening Questionnaire (Diagnostic Criteria for Temporomandibular Disorders – DC/TMD), the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety and Stress Scale (DASS-21), and the sleep and awake bruxism questionnaire. ANOVA test and Mann Whitney post-test were used, with Bonferroni adjustment (p&lt;0.016) and a 95% confidence level. Results: Probable TMD was found in 24.3% (n=156) of the participants, while possible sleep and awake bruxism were diagnosed in 58% (n=372) and 53.8% (n=345) of them, respectively. Among all variables evaluated, only symptoms of depression were significantly greater in the quarantined DSs group when compared to those who were working at the clinical care (p=0.002). Working DSs were significantly less likely (OR=0.630, p=0.001) to have depressive symptoms. Those who were not worried or less worried about the pandemic were less likely to experience stress (OR=0.360), anxiety (OR=0.255), and poor sleep quality (OR=0.256). Sleep had a strong positive and moderate correlation with psychological factors on frontline workers and DSs in outpatient care, respectively.&nbsp;Conclusion: The results suggest confinement may have a more negative impact on the life of DSs than the act of being actively working. The concern about Covid-19 and poor sleep quality was significantly prevalent and may negatively affect the quality of life of DSs. Thus, further research on the topic is needed

The association of self-reported awake bruxism with anxiety, depression, pain threshold at pressure, pain vigilance, and quality of life in patients undergoing orthodontic treatment

This study aimed to evaluate whether the presence of awake bruxism was associated with temporomandibular dysfunction symptoms, pain threshold at pressure, pain vigilance, oral health-related quality of life (OHRQoL), and anxiety and depression symptoms in patients undergoing orthodontic treatment.&nbsp;Methodology: This observational study followed patients who had started receiving orthodontic treatment for six months. The following variables were measured three times (at baseline, one month, and six months): pressure pain threshold (PPT) in the right and left masseter, anterior temporalis, and temporomandibular joint (TMJ), and right forearm; pain vigilance and awareness questionnaire; and shortened form of the oral health impact profile (OHIP-14). Anxiety and depression symptoms were measured using the Beck anxiety inventory and the Beck depression inventory, respectively. The patients were divided into two main groups according to the presence (n=56) and absence (n=58) of possible awake bruxism. The multi-way analysis of variance (ANOVA) was applied on the date (p=0.050).&nbsp;Results: TMJ and/or muscle pain were not observed in both groups. Time, sex, age group, and awake bruxism did not affect the PPT in the masticatory muscles and pain vigilance (p&gt;0.050). However, the primary effect of awake bruxism was observed when anxiety (ANOVA: F=8.61, p=0.004) and depression (ANOVA: F=6.48, p=0.012) levels were higher and the OHRQoL was lower (ANOVA: F=8.61, p=0.004).&nbsp;Conclusion: The patients with self-reported awake bruxism undergoing an orthodontic treatment did not develop TMJ/masticatory muscle pain. The self-reported awake bruxism is associated with higher anxiety and depression levels and a poorer OHRQoL in patients during the orthodontic treatment

Coronoid process hyperplasia: an unusual cause of mandibular hypomobility

A large number of disorders affecting the masticatory system can cause restriction of mouth opening. The most common conditions related to this problem are those involving the temporomandibular joint (TMJ) and the masticatory muscles, when facial pain also is an usual finding. Congenital or developmental mandibular disorders are also possible causes for mouth opening limitation, although in a very small prevalence. Coronoid process hyperplasia (CPH) is an example of these cases, characterized by an excessive coronoid process growing, where mandibular movements become limited by the impaction of this structure on the posterior portion of the zygomatic bone. This condition is rare, painless, usually bilateral and progressive, affecting mainly men. Diagnosis of CPH is made based on clinical signs of mouth opening limitation together with imaging exams, especially panoramic radiography and computerized tomography (CT). Treatment is exclusively surgical. This paper presents a case of a male patient with bilateral coronoid process hyperplasia, initially diagnosed with bilateral disk displacement without reduction, and successfully treated with intraoral coronoidectomy. It is emphasized the importance of differential diagnosis for a correct diagnosis and, consequently, effective management strategy

Inadequate swallowing is associated to masticatory myofascial pain?

JUSTIFICATIVA E OBJETIVOS: Os músculos da mastigação, envolvidos na fisiopatologia da dor miofascial mastigatória, também participam da função de deglutição. Diante dos resultados controversos sobre a relação entre disfunção temporomandibular (DTM) e alterações na deglutição, o objetivo deste estudo foi verificar a presença de alterações na função da deglutição em mulheres com dor miofascial mastigatória. MÉTODO: Três testes de deglutição (um sólido e dois líquidos) foram realizados em 30 mulheres com dor miofascial (grupo de estudo = GE) e 30 mulheres saudáveis (grupo controle = GC). Alterações nos padrões de deglutição como: contração da musculatura periorbicular, contração mentual, movimentos de cabeça, deglutição acompanhada de ruído, engasgos, interposição de lábio inferior, dor após deglutição e deglutição com projeção de língua para anterior foram observadas durante os três testes. Os resultados foram descritos e comparados entre os grupos através dos testes Qui-quadrado e Exato de Fisher com nível de significância de 0,05 e intervalo de confiança a 95%. RESULTADOS: Participantes do GE apresentaram chance maior de presença de atipias durante um dos testes de deglutição de líquido [teste Qui-quadrado; p < 0,05; OR: 3,29; IC 95% (1,08 - 9,95)]. Entretanto, não houve associação entre a presença de DTM e características atípicas da deglutição avaliadas em todos os testes. CONCLUSÃO: Deglutição inadequada esteve associada com a presença de dor miofascial mastigatória apenas durante a ingestão de líquido. Entretanto, não foi possível associar um tipo específico de atipia à DTM nesta amostra

Prevalence of temporomandibular disorder in patients with fibromyalgia: a systematic review / Prevalência de distúrbio temporomandibular em pacientes com fibromialgia: uma revisão sistemática

INTRODUCTION: Temporomandibular Disorders (TMDs) and Fibromyalgia (FM) may share similar signs and symptoms. Among them, muscle pain may be involved and significantly reduce the quality of life of these patients. AIM: The aim of this systematic review was to determine the prevalence of TMD in patients with FM.MATERIALS AND METHODS: In this systematic review six electronic databases (LILACS, LIVIVO, PubMed, ScienceDirect, PsycINFO, and Web of Science), as well as three grey literature databases (Google Scholar, Open Grey, and ProQuest) were searched. Cross-sectional studies were selected by two independent reviewers and analyzed in two-phases, following the PRISMA statement. Risk of bias was assessed through the MASTARI (Meta-Analysis of Statistics Assessment and Review Instrument for observational studies from the Joana Briggs Institute).RESULTS: From 660 articles, 51 were eligible for full-text reading and six were finally included. None of the articles met all quality methodological criteria. Therefore, considering the overall risk of bias, one article was judged with moderate risk and five with low risk of bias. A heterogeneity was considered high; thus, a meta-analysis was not performed. From the qualitative analysis it was possible to determine that between 13% to 87.1% of patients with FM can present TMD.CONCLUSION: The prevalence of TMD in patients with FM ranged from 13% to 87.1%. It is suggested that further studies be carried out, mainly with longitudinal design and better quality methodology to help answer whether fibromyalgia is a risk factor for the development of TMDs

Assessment of awake bruxism in undergraduate students, using Ecological Momentary Assessment, through WhatsApp

This study assessed awake bruxism (AB) in undergraduate students using WhatsApp and examined the association of this behavior with quality of life and anxiety. The sample was composed of 36 healthy young adults of both genders, with an average age of 20.74 years. AB behaviors (teeth contact, teeth clenching, teeth grinding and mandible bracing) and relaxed jaw muscles were reported with Ecological Momentary Assessment, through WhatsApp, 15 times a day, for 7 days, between 8:00 am and 7:00 pm. Quality of Life (QoL) and anxiety were assessed using the SF-36 and GAD-7 questionnaires, respectively. The Mann-Whitney U non-parametric, Pearson and Spearman correlation and Pairwise non-parametric multiple comparisons 2- to-2 tests were used. The frequency of AB was 40.7%. The most frequent AB behavior was teeth contact (23.1%). Higher frequency of AB occurred on weekdays (42.3%) compared to the weekend (35.5%) (p&lt;0.05). There was a negative correlation of AB behaviors and mandible bracing with the QoL - emotional aspects domain (p&lt;0.05) and positive correlation of mandible bracing with anxiety (p&lt;0.01). There was no difference between genders for QoL, anxiety and AB behaviors (p&gt;0.05). This study highlights the importance of AB and anxiety control to improve undergraduate students’ quality of life.This study assessed awake bruxism (AB) in undergraduate students using WhatsApp and examined the association of this behavior with quality of life and anxiety. The sample was composed of 36 healthy young adults of both genders, with an average age of 20.74 years. AB behaviors (teeth contact, teeth clenching, teeth grinding and mandible bracing) and relaxed jaw muscles were reported with Ecological Momentary Assessment, through WhatsApp, 15 times a day, for 7 days, between 8:00 am and 7:00 pm. Quality of Life (QoL) and anxiety were assessed using the SF-36 and GAD-7 questionnaires, respectively. The Mann-Whitney U non-parametric, Pearson and Spearman correlation and Pairwise non-parametric multiple comparisons 2- to-2 tests were used. The frequency of AB was 40.7%. The most frequent AB behavior was teeth contact (23.1%). Higher frequency of AB occurred on weekdays (42.3%) compared to the weekend (35.5%) (p&lt;0.05). There was a negative correlation of AB behaviors and mandible bracing with the QoL - emotional aspects domain (p&lt;0.05) and positive correlation of mandible bracing with anxiety (p&lt;0.01). There was no difference between genders for QoL, anxiety and AB behaviors (p&gt;0.05). This study highlights the importance of AB and anxiety control to improve undergraduate students’ quality of life