Chronic pain and depression as factors associated with temporomandibular dysfunction in older adults with Parkinson's disease

Faccio, Patrícia Fernanda; Tavares, Raíssa Barreto; Asano, Nadja Maria Jorge; Asano, Amdore Guescel C; Coriolano, Maria das Graças Wanderley de Sales; Lins, Carla Cabral dos Santos Accioly

doi:10.1590/1982-0216/20202247719

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ORIGINAL ARTICLES • Rev. CEFAC 22 (4) • 2020 • https://doi.org/10.1590/1982-0216/20202247719 copy

Chronic pain and depression as factors associated with temporomandibular dysfunction in older adults with Parkinson's disease

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

to investigate whether chronic pain and depression are factors associated with temporomandibular dysfunction (TMD) in older adults with Parkinson's disease.

Methods:

a cross-sectional study using the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire. The clinical variables studied were chronic pain, depression, nonspecific physical symptoms including and excluding items of pain, and dentures use. The associations between the dependent and independent variables were evaluated by the chi-square odds ratio, with a 95% confidence interval.

Results:

a total of 81 older adults met the eligibility criteria - 67% were males, 74% were married or had a partner, 43% reported earning 1 to 2 minimum wages, and 47% were in the moderate stage of Parkinson's disease. TMD was identified in 22% of the sample, 12% reporting chronic pain. The statistical analysis showed an association between TMD and chronic pain (p = 0.001, OR = inf, 95% CI = 12.13 - inf) and between TMD and moderate-to-severe depression (p = 0.014, OR = 4.8, 95% CI = 1.14 - 23.51).

Conclusion:

it was verified that chronic pain and moderate-to-severe depression were the factors associated with TMD in older adults presented with Parkinson's disease.

Keywords:
Parkinson's Disease; Aged; Temporomandibular Joint Disorders; Chronic Pain; Depression

Variables	N = 81	Frequency (%)
Age
60 - 69 years	42	52%
70 - 79 years	35	43%
80 years or more	4	5%
Gender
Males	54	67%
Females	27	33%
Schooling level
Illiterate	5	6%
1 - 4 years at school	20	25%
5 - 8 years at school	22	27%
9 - 11 years at school	17	21%
12 - 17 years at school	17	21%
Marital status
Married or has a partner	60	74%
Separated or divorced	6	7%
widow/widower	9	11%
single	5	6%
Income (MW)*
Less than 1	5	6%
From 1 to 2	35	43%
From 3 to 5	29	36%
From 6 to 10	7	9%
From 11 to 20	3	4%
Could not inform	2	2%
Stages of Parkinson’s disease
Mild stage 1	20	25%
Moderate stages 2 and 3	60	74%

Variables	N=81	Frequency (%)
Temporomandibular Dysfunction
Presence	18	22%
Absence	63	88%
Degree of Chronic Pain
Degree 0	71	88%
Degree I	7	9%
Degree II	2	2%
Degree III	0	0%
Degree IV	1	1%
Degree of Depression
Normal	34	42%
Moderate	28	35%
Serious / Severe	19	23%
NPS including items of pain*
Normal	33	41%
Moderate	19	23%
Serious / Severe	29	36%
NPS excluding items of pain *
Normal	29	36%
Moderate	16	20%
Serious / Severe	36	44%
Dentures use
Yes	35	43%
No	46	57%

Variables		With TMD	Without TMD	Total
Chronic Pain	With pain	10	0	10	p-value = 0.001 OR = inf 95% CI = 12.13-inf Kappa = 0.66 Sens = 0.55 Spe = 1.00 PPV = 1.00 NPV = 0.88
	Without pain	8	63	71
	Total	18	63	81
Depression	With depression	15	32	47	p-value = 0.014 OR = 4.8 95% CI = 1.14 - 23.51 Kappa = 0.207 Sens = 0.83 Spe = 0.49 PPV = 0.31 NPV = 0.91
	Without depression	3	31	34
	Total	18	63	81
NPS including items of pain	Yes	13	35	48	p-value = 0.20 OR = 2.00 95% CI = 0.59 - 7.67
	No	5	28	33
	Total	18	63	81
NPS excluding items of pain	Yes	14	28	52	p-value = 0.17 OR = 2.3 95% CI = 0.6 - 9.4
	No	4	25	29
	Total	18	63	81
Dentures use	With dentures	6	29	35	p-value = 0.33 OR = 0.58 95% CI = 0.16 - 1.97
	Without dentures	12	34	46
	Total	18	63	81

ABRAMO Associação Brasileira de Motricidade Orofacial Rua Uruguaiana, 516, Cep 13026-001 Campinas SP Brasil, Tel.: +55 19 3254-0342 - São Paulo - SP - Brazil
E-mail: revistacefac@cefac.br

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[1] Corresponding address: Patrícia Fernanda Faccio, Parque Gonçalves Lêdo, nº139, Farol, CEP: 57051-340 - Maceió, Alagoas, Brasil, E-mail: patyfaccio@hotmail.com