Subjective sleep complaints were associated with painful temporomandibular disorders in adolescents: The Epidor-Adolescere study.

BACKGROUND: Sleep disturbances in adolescents has received a lot of attention in the literature and it is recognised as a serious health concern. The association between pain and sleep disturbances in adolescents has been extensively studied. However, to the best of our knowledge, there is a lack of studies investigating the association between various subjective sleep variables and painful TMD in adolescents. OBJECTIVES: to investigate the association between painful TMD and subjective sleep variables in adolescents' non-clinical sample. We conducted a cross-sectional study. TMD was classified according to the RDC/TMD criteria. The Revised Face Scale evaluated TMD pain intensity, and pressure pain thresholds (PPTs) were assessed in trigeminal and extra-trigeminal areas. The subjective sleep variables were assessed according to the Sleep Disturbance Scale for Children and Sleep Behaviour Questionnaire. RESULTS: The final sample consisted of 690 adolescents (12.7 ± 0.76 years), with 16.2% of them presenting painful TMD. Adolescents who frequently reported waking up more than twice per night and feeling tired when awake were more likely to present painful TMD symptoms [OR = 1.7 (95% CI: 1.04-2.90); p = .034 and OR = 1.6 (95% CI: 1.01-2.48); p = .046, respectively]. The intensity of TMD pain was negatively associated with sleep quality (p = .015). Also, PPT values in the trigeminal and extra-trigeminal areas were negatively associated with total sleep time (p = .048 and p = .042, respectively). CONCLUSIONS: The present results point out the importance of considering sleep complaints associated with painful TMD in adolescents.

Temporomandibular disorder, body pain and systemic diseases: assessing their associations in adolescents.

Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification. OBJECTIVE: To investigate the presence of other painful conditions and systemic diseases and their association with painful TMD. METHODOLOGY: In this cross-sectional study, 690 adolescents aged between 12-14 years old were evaluated through questionnaires and clinical examinations. RESULTS: Painful TMD was found in 16.2% of the sample, with a significant association with bronchitis (OR= 2.5; p=0.003) and asthma (OR=3.1; p=0.013), reported by the parents/legal guardians of the participants. Adolescents with regional and widespread pain were 2.7 (95% CI: 1.65-4.55) and 3.6 (95% CI: 1.29-10.14) more likely to also present painful TMD. Painful TMD was associated with a higher number of body pain sites in the last 12 months (4.26 vs. 2.90; p<0.001), as well as a higher number of systemic diseases (1.48 vs. 1.18; p=0.048), when compared to adolescents without painful TMD. CONCLUSION: The findings of this study point out the importance of considering the presence of comorbid conditions in the diagnosis and management of painful TMD in adolescents. A multidisciplinary approach would contribute to better control of painful TMD and decrease its chronification risk.

Temporomandibular disorder, body pain and systemic diseases: assessing their associations in adolescents

Abstract Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification. Objective To investigate the presence of other painful conditions and systemic diseases and their association with painful TMD. Methodology In this cross-sectional study, 690 adolescents aged between 12-14 years old were evaluated through questionnaires and clinical examinations. Results Painful TMD was found in 16.2% of the sample, with a significant association with bronchitis (OR= 2.5; p=0.003) and asthma (OR=3.1; p=0.013), reported by the parents/legal guardians of the participants. Adolescents with regional and widespread pain were 2.7 (95% CI: 1.65-4.55) and 3.6 (95% CI: 1.29-10.14) more likely to also present painful TMD. Painful TMD was associated with a higher number of body pain sites in the last 12 months (4.26 vs. 2.90; p<0.001), as well as a higher number of systemic diseases (1.48 vs. 1.18; p=0.048), when compared to adolescents without painful TMD. Conclusion The findings of this study point out the importance of considering the presence of comorbid conditions in the diagnosis and management of painful TMD in adolescents. A multidisciplinary approach would contribute to better control of painful TMD and decrease its chronification risk.

Avaliação da obesidade na prevalência e gravidade das disfunções temporomandibulares / Evaluation of obesity in prevalence and severity of temporomandibular disorders

Objetivo: A obesidade é uma doença crônica, prevalente e comórbida com condições dolorosas como as musculoesqueléticas. A Disfunção Temporomandibular (DTM) é uma dor musculoesquelética altamente prevalente. O objetivo desse estudo foi avaliar a relação entre obesidade com a presença e gravidade de DTM dolorosa. Métodos: A amostra foi estratificada de acordo com a presença e grau de DTM dolorosa de acordo com o Research Diagnostic Criteria para Temporomandibular Disorders-Eixo I e II (RDC/TMD). A composição corporal foi determinada pelo Índice de Massa Corporal (IMC) e pelo exame de bioimpedância (BIA). As cefaleias primárias (CP) foram classificadas segundo critérios da Classificação Internacional de Cefaléia II (CIC-II). Análises uni e multivariadas avaliaram associação entre DTM dolorosa e obesidade. Resultados: A amostra foi constituída por 245 indivíduos (35,89 ± 12,61 anos), sendo 183 (74,7%) mulheres. Do total, 130 (53,25%) apresentaram DTM dolorosa. Houve associação significativa entre a presença de DTM dolorosa e sobrepeso/obesidade avaliada por BIA (RP = 1,44, IC 95% = 1,09-1,91). Associação se manteve em análise multivariada corrigido por gênero e presença de cefaleias crônicas diárias (CCD) (OR= 2,02, IC95%: 1,16-3,54). Não houve associação significativa entre a gravidade de DTM e a composição corporal segundo IMC (p= 0,06) ou BIA (p= 0,08). Conclusão: Obesidade está associada a presença de DTM dolorosa, mas não com a gravidade, após o ajuste para CCD e gênero.

Objectives: Obesity is a chronic and prevalent disorder, comorbid with painful conditions such as musculoskeletal disease. Temporomandibular disorders (TMD) are a high prevalent musculoskeletal pain. The aim of this study was to evaluate the relationship between obesity and the presence and degree of painful TMD. Methods: The sample was stratified according to the presence of painful TMD following the Research Diagnostic Criteria for Temporomandibular Disorders- Axis I and II (RDC/TMD) criteria. The body composition was assessed through Body Mass Index (BMI) and bioimpedance (BIA) analysis. The primary headaches (PH) were classified according to the International Classification for Headache Disorders II (ICHD-II). Uni and multivariate analysis assessed the association between painful TMD and obesity. Results: The sample consisted of 245 individuals (35.89 ± 12.61 years), 183 (74.70%) of them were women. Of the total, 130 (53.25%) presented painful TMD. In contrast with normal weighted individuals, those presenting overweight/obesity according to BIA were more likely to present painful TMD (PR= 1.44, 95%CI= 1.09 to 1.91). Association persisted in multivariate analysis correcting for gender and presence of chronic daily headache (CDH) (OR = 2.02, 95%CI: 1.16 to 3.54). There was no significant association between the grade of the TMD pain and body composition assessed through BMI (p= 0.06) or BIA (p= 0.08). Conclusion: Obesity is associated with the presence of painful TMD, but not with the grade of TMD pain, after adjustment for the CDH and gender

Burnout in dental students: effectiveness of different methods / Síndrome de Burnout em estudantes de Odontologia: efetividade de diferentes métodos

Objetivo: Este estudo teve por objetivo estimar a efetividade de diferentes métodos de rastreamento da Síndrome de Burnout em estudantes de Odontologia. Material e Método: Utilizou-se o Inventário de Oldenburg (OLBI-SS) e o Inventário de Copenhagen (CBI-SS). Como padrão-ouro utilizou-se o Inventário de Burnout de Maslach (MBI-SS). As qualidades psicométricas dos instrumentos foram estimadas. O modelo hierárquico de segunda ordem foi estimado para cálculo do escore global do OLBI-SS e do CBI-SS. As curvas ROC foram construídas e as áreas estimadas (AUROC). Resultado: Participaram 235 estudantes de um curso de graduação. Os instrumentos apresentaram adequada confiabilidade e validade e para tanto, foi necessário remover três questões do OLBI-SS e uma do CBI-SS. Conclusão: Observou-se boa capacidade discriminante das dimensões Exaustão do OLBI-SS e BP e BRE do CBI-SS. O CBI-SS apresentou capacidade discriminante superior à do OLBI-SS na identificação da Síndrome de Burnout (DAUROC=.172 [.103-.240]; p<.05).

Objective: This study was proposed to estimate the effectiveness of different screening methods of the Burnout Syndrome among dental students. Material and Method: The Burnout Syndrome assessment was performed using the Oldenburg Inventory-Student survey (OLBI-SS) and the Copenhagen Inventory-Student survey (CBI-SS). The Maslach Burnout Inventory-Student survey (MBI-SS) was used as the gold standard. The psychometric properties of the instruments were measured. The second-order hierarchical model was estimated to calculate the overall scores for OLBI-SS and CBI-SS, and ROC curves were constructed and the areas were estimated (AUROC). Result: A total of 235 undergraduate students participated in this study. The instruments showed an adequate reliability and validity; however three questions had to be removed from OLBI-SS and one from CBI-SS. The Exhaustion dimension of OLBI-SS, and Personal Burnout and Study related Burnout of CBI-SS presented a good discriminating capacity. Conclusion: CBI-SS showed higher discriminating capacity, than OLBI-SS, to identify the Burnout Syndrome (DAUROC=.172 [.103-.240]; p<.05).

Influência de abordagens biopsicossociais e autocuidados no controle das disfunções temporomandibulares crônicas / Influence of biopsychosocial approaches and self-care to control chronic pain and temporomandibular disorders

BACKGROUND AND OBJECTIVES: Temporomandibular joint disorder (TMD), which is a musculoskeletal condition of the masticatory system, may become chronic and further worsen quality of life (QL) of patients. Due to the interrelation between physical and emotional symptoms, there is increasing search for the integrative model, which includes psychosocial approaches for the treatment of painful conditions. This study aimed at reviewing in the literature the impact of education and simple self-care modalities on pain and disorders related to chronic painful TMD. CONTENTS: Psychosocial factors are often involved with pain chronicity, making bio-behavioral approaches increasingly more indicated to change pain perception and to decrease distress and psychosocial changes which go along with persistent pain. CONCLUSION: Current literature, although not extensive, indicates positive results of education and self-care methods for chronic painful TMD. Further studies are needed to reinforce such findings and spread the application of such approaches to control chronic and TMD pain.

JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM), condição musculoesquelética do sistema mastigatório, pode se tornar crônica, causando maior comprometimento na qualidade de vida (QV) dos pacientes. Devido à inter-relação entre sintomas físicos e emocionais, há uma crescente busca pelo modelo integrativo, o qual inclui abordagens psicossociais para o tratamento de condições dolorosas. O objetivo deste estudo foi realizar uma revisão de literatura sobre o impacto da educação e modalidades simples de autocuidados podem ter na dor e na disfunção relacionadas à DTM dolorosa crônica. CONTEÚDO: Os fatores psicossociais estão frequentemente envolvidos na cronificação da dor, tornando as abordagens biocomportamentais cada vez mais indicadas para mudar a percepção da dor, reduzir o sofrimento e as alterações psicossociais que acompanham as dores persistentes. CONCLUSÃO: A literatura existente, apesar de não ser vasta, indica resultados positivos da aplicação de métodos de educação e autocuidados em DTM dolorosa crônica. Mais estudos são necessários para reforçar tais achados e disseminar a aplicação de tais abordagens no controle da dor crônica e da DTM.

Burnout syndrome among dental students.

The burnout syndrome is characterized by professional exhaustion and has been reported in college students. The aim of this study was to estimate the prevalence of Burnout Syndrome among dentistry students from a public university, and its relationship to socio-demographic characteristics. All students (n = 300) were invited to participate. We used the Maslach Burnout Inventory-Student Version (MBI-SS). We carried out an analysis of the MBI-SS' psychometric properties. Multivariate Analysis of Variance (MANOVA) was performed, followed by Analysis of Variance (ANOVA) and Tukey's post-hoc tests to compare the mean scores of burnout dimensions. Of the 235 participants, 72.8% were women and the mean age was 21.0 ± 1.8 years. The MBI-SS was reliable and valid. Of the students, 17.0% had Burnout Syndrome. There was a significant relation between Burnout Syndrome and a student's performance during the course (F = 4.433, p < 0.001), medication intake because of studies (F = 7.721, p < 0.001), and the thought of dropping the course (F = 16.168, p < 0.001). The students most affected were those with poor performance, those who took medication because of studies, and those with thoughts of dropping the course. We concluded that the prevalence of the syndrome among dentistry students was high, with a significant relation between the syndrome and a student's academic performance, use of medication because of studies, and thoughts of dropping the course.

Síndrome de Burnout em graduandos de Odontologia / Burnout syndrome among dental students

A Síndrome de Burnout caracteriza-se por esgotamento profissional e tem sido relatada em estudantes universitários. O objetivo desse estudo foi estimar a prevalência da Síndrome de Burnout em estudantes de Odontologia de uma universidade pública e sua relação com características sociodemográficas. Todos os estudantes (n = 300) foram convidados a participar. Utilizou-se o Inventário de Burnout de Maslach - versão estudantes (MBI-SS). Realizou-se análise das propriedades psicométricas do MBI-SS. Para comparação entre os escores médios das dimensões do Burnout realizou-se Análise de Variância Multivariada (MANOVA) seguida de Análise de Variância (ANOVA) e testes post-hoc de Tukey. Dos 235 participantes, 72,8 por cento eram mulheres e a média de idade era de 21,0 ± 1,8 anos. O MBI-SS mostrou-se confiável e válido. Dos estudantes, 17,0 por cento apresentaram a Síndrome de Burnout. Verificou-se relação significativa entre a Síndrome de Burnout e o desempenho do estudante no curso (F = 4,433, p < 0,001), o consumo de medicação devido aos estudos (F = 7,721, p < 0,001) e o pensamento de desistir do curso (F = 16,168, p < 0,001). Foram mais acometidos aqueles com desempenho ruim no curso, que consomem medicações devido aos estudos e que já pensaram em desistir do curso. Conclui-se que a prevalência da Síndrome entre os estudantes de Odontologia foi alta, sendo significativa a relação entre a Síndrome e o desempenho do estudante no curso, o consumo de medicação devido aos estudos e o pensamento de desistir do curso.

The burnout syndrome is characterized by professional exhaustion and has been reported in college students. The aim of this study was to estimate the prevalence of Burnout Syndrome among dentistry students from a public university, and its relationship to socio-demographic characteristics. All students (n = 300) were invited to participate. We used the Maslach Burnout Inventory - Student Version (MBI-SS). We carried out an analysis of the MBI-SS' psychometric properties. Multivariate Analysis of Variance (MANOVA) was performed, followed by Analysis of Variance (ANOVA) and Tukey's post-hoc tests to compare the mean scores of burnout dimensions. Of the 235 participants, 72.8 percent were women and the mean age was 21.0 ± 1.8 years. The MBI-SS was reliable and valid. Of the students, 17.0 percent had Burnout Syndrome. There was a significant relation between Burnout Syndrome and a student's performance during the course (F = 4.433, p < 0.001), medication intake because of studies (F = 7.721, p < 0.001), and the thought of dropping the course (F = 16.168, p < 0.001). The students most affected were those with poor performance, those who took medication because of studies, and those with thoughts of dropping the course. We concluded that the prevalence of the syndrome among dentistry students was high, with a significant relation between the syndrome and a student's academic performance, use of medication because of studies, and thoughts of dropping the course.