Tuesday, February 24, 2015

PG - Useful information about TMD and Sleep quality correlation for your patients!

From a journal review by Vince Kokich in AO 2003, found this interesting bit about Sleep Quality and TMD. Something which you can confidently inform your patients about!

Sleep quality is a cofactor in temporomandibular disorders. TMD affects a portion of the patients treated by orthodontists. Although orthodontic therapy will not predictably ameliorate temporomandibular disorders, it is important to understand the pathology of TMD, and how it could affect or be affected by tooth movement. A recent study published in the Journal of Orofacial Pain (2002;16: 221–228), evaluated the quality of sleep as a participating factor in TMD. The sample for this study consisted of 137 consecutive subjects who had presented for evaluation at a university-based temporomandibular clinic. These individuals had a variety of problems, but all had varying degrees of craniomandibular pain and dysfunction. Before rendering any treatment, each subject was asked to complete three questionnaires. The first evaluated their quality of sleep, the second determined the subject’s level of psychological stress, and the third evaluated the degree of craniomandibular pain. From this data, the subjects were divided into two groups—good sleepers and poor sleepers. Then, the level of psychological stress and the degree of pain were compared between the two groups. The authors found that poor sleepers typically had higher psychological stress, higher pain, and less perceived life control. Furthermore, the authors determined that the quality of sleep could be predicted by the intensity of pain and the degree of psychological stress in patients with TMD. As a result, the authors concluded that sleep quality is a cofactor in many subjects with temporomandibular disorders.

Personally I have had good experiences where posterior crossbites, especially second molar complete buccal crossbites, when treated successfully eliminated pretreatment TMJ pain. However, the above article is worth keeping in mind when TMD doesnt seem to respond to therapy.

Whether a vice-versa situation i.e. whether TMD is the cause of poor sleep quality is worth another investigation!


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