Background & Aims

Painful temporomandibular disorders (p-TMD) are the most common non-odontogenic chronic orofacial pain [1]. Previous research has reported co-morbidity between TMD and cervical spinal pain [2]. Shared pathophysiological mechanisms may underlie such musculoskeletal pain conditions at various locations. While some cross-sectional studies have identified an association between the presence of p-TMD and the presence of spinal pain [3-5], a comprehensive understanding of this relationship is lacking in the existing literature [6]. Notably, spinal pain is prevalent among children [7]. Therefore, this study aimed to investigate the association between pre-adolescent spinal pain and the presence of p-TMD in young adulthood.

Methods

The present cohort study utilized data from the Danish National Birth Cohort (DNBC), focusing on participants aged 18 and above, who completed the TMD pain screener. Information on spinal pain (neck, middle back, and low back pain) was derived from the DNBC 11-year follow-up using a sub-division of the Young Spine Questionnaire (YSQ) and categorized by intensity and frequency in 3 groups: group 1 (mild or no pain with low frequency), group 2 (moderate pain with medium frequency), group 3 (severe pain with high frequency) [7]. Logistic regression models, adjusted for confounding factors (sex, sleep quality, mental health, and maternal socio-occupational status), were employed. To address selection bias, inverse probability weighting (IPW) for participation was implemented in the analyses, aiming to estimate the association between pre-adolescence spinal pain and p-TMD in young adulthood.

Results

In total 11,982 participants completed the TMD pain screener. Of these, data on spinal pain were available for 9,639 individuals (65% females). The analyses revealed statistically significant associations between neck pain and p-TMD TMD (OR group2/group1 =1.37 [95% C.I., 1.22-1.55] and OR group3/group1 =1.85 [95% C.I., 1.52-2.26]), middle back pain and p-TMD (OR group2/group1 =1.23 [95% C.I., 1.06-1.44] and OR group 3/group1 =1.86 [95% C.I., 1.46-2.38]), and low back pain and p-TMD (OR group2/group1 =1.30 [95% C.I., 1.11-1.52] and OR group3/group 1 =2.22 [95% C.I., 1.67-2.95]) in adjusted analyses. Similarly, a significant association was observed between overall spinal pain and p-TMD (OR group2/group1 =1.29 [95% C.I., 1.15-1.45] and OR group3/group1 =1.91 [95% C.I., 1.61-2.25]).

Conclusions

The present study demonstrated a connection between spinal pain in pre-adolescence and the presence of p-TMD in young adulthood. The observed association aligns with previous cross-sectional research, emphasizing the importance for clinicians to screen for pains in multiple locations when assessing either condition [3-5]. Recognizing the connection highlights the need to manage pain comprehensively, addressing both jaw and spine health. These results stress the importance of considering musculoskeletal health from childhood to adulthood, offering insights that could help shape early interventions for those at risk of developing p-TMD.

References

1.McNeill, C., Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent, 1997. 77(5): p. 510-22.
2.De Laat, A., et al., Correlation between cervical spine and temporomandibular disorders. Clinical oral investigations, 1998. 2: p. 54-57.
3.Kim, D., et al., The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study. BMC Musculoskeletal Disorders, 2019. 20(1): p. 1-13.
4.Wiesinger, B., et al., Does a dose-response relation exist between spinal pain and temporomandibular disorders? BMC Musculoskeletal Disorders, 2009. 10(1): p. 1-8.
5.Walczy?ska-Dragon, K., et al., Correlation between TMD and cervical spine pain and mobility: is the whole body balance TMJ related? BioMed research international, 2014. 2014.
6.Justribó?Manion, C., et al., Is low back pain a risk/prognostic factor for the development and/or progression of temporomandibular disorders? A systematic review with meta?analysis. Journal of Oral Rehabilitation, 2023.
7.Joergensen, A.C., et al., Epidemiology of spinal pain in children: a study within the Danish National Birth Cohort. European Journal of Pediatrics, 2019. 178: p. 695-706.

Presenting Author

Mojdeh Mansoori

Poster Authors

Mojdeh Mansoori

MSc

Aarhus University

Lead Author

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Cristina Exposto

Aarhus University

Lead Author

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Bodil Hammer Beck

Aarhus University, Department of Public Health - Epidemiology

Lead Author

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Luda Diatchenko

McGill University

Lead Author

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Lene Baad-Hansen

Aarhus University

Lead Author

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Topics

  • Models: Musculoskeletal