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Influence of Psychological Factors on Risk of Temporomandibular Disorders

¹ Australian Research Centre for Population Oral Health, Dental School, University of Adelaide, SA 5005, Australia;
² University of North Carolina, Chapel Hill, USA;
³ Chulalongkorn University, Bangkok, Thailand;
⁴ Public Health Services and Research, University of Florida College of Dentistry, Gainesville, USA;
⁵ NIDCR, NIH, DHHS, Bethesda, MD, USA; and
⁶ NIAAA, NIH, DHHS, Rockville, MD, USA

View larger version (24K): [in this window] [in a new window]   Figure 1. TMD incidence rates for high- and low-pain sensitivity phenotypes and for COMT haplotypes. Data are from n = 171 participants with 5 common haplotypes of COMT and who completed at least one follow-up assessment in the three-year cohort study. Vertical bars depict average annual incidence rates per 100 person-years, with error bars representing 95% confidence intervals. We computed temporomandibular disorder (TMD) incidence by dividing the number of new cases of TMD by the total number of person-years of follow-up. Groups are contrasted based on haplotypes of COMT and pain phenotype scores. Pain phenotype scores represent the sum of responses to 13 experimental pain procedures, in which each response (i.e., pain rating, threshold, or tolerance) was transformed to a unit normal deviate (z-score). The summary pain phenotype score, which represents the sum of standard deviations above or below the overall mean for all 13 responses, was dichotomized at the approximate upper tertile of the distribution. The PSH (pain-sensitive haplotypes) group consisted of individuals carrying haplotypes ACCG or ATCA for the sequence of SNPs rs6269, rs4633, rs4818, and val158met (Diatchenko et al., 2005). The PRH (pain-resistant haplotype) group consisted of individuals carrying at least one haplotype GCGG for the same sequence of SNPs. Incidence density ratios (IDRs) and 95% confidence intervals (IDR) were calculated by univariate Poisson regression. 95% CIs of IDR for both COMT haplotype and experimental pain exclude the null value of 1.0, and therefore represent statistically significant differences in TMD risk among groups.

View larger version (25K): [in this window] [in a new window]   Figure 2. TMD incidence rates and haplotype prevalence in psychological subgroups. Data are from n = 171 participants with 5 common haplotypes of COMT and who completed at least one follow-up assessment in the three-year cohort study. The number of participants in each psychological subgropup is shown in parentheses and may not sum to 171, due to missing values of psychological variables. Unshaded bars depict annual incidence rates and 95%CIs for TMD, computed as described for Fig. 1. Shaded bars depict percentage (and 95%CIs) of people with pain-sensitive haplotypes in each psychological subgroup. BSI = Brief Symptom Inventory; POMS = Profile of Mood States questionnaire. Incidence density ratios (IDRs) were computed as described for Fig. 1. Prevalence ratios were computed with Cochran-Mantel-Haenszel estimates. IDR 95%CIs for all 3 psychological factors exclude the null value of 1.0, and therefore represent statistically significant differences in TMD risk among psychological groups. Prevalence ratio and 95%CIs for all psychological factors include the null value of 1.0, and therefore represent statistically non-significant differences among psychological groups in percentages of people with pain-sensitive haplotypes.

Journal of Dental Research, Vol. 86, No. 11, 1120-1125 (2007)
DOI: 10.1177/154405910708601119


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