Biopsychosocial correlations in patients with chronic oro-facial pain. Part II. Experiences of pain and dramatic events before the 16th year of life

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Abstract

Before the sixteenth year of life, biopsychosocial influences such as self-experienced and observed accidents/illnesses, adverse medical/dental treatments, dangerous events and self-experienced or observed force seem to affect the manifestation of chronic pain in the oro-facial area in the forms of temporomandibular disorder (TMD) and psychogenic denture-intolerance (PDI)/somatoform oro-facial pain (SOP). We evaluated the occurrence of these types of events before the age of 16 years in 50 TMD patients, 55 PDI/SOP patients and 55 randomly selected pain-free control group (CG) using the medical questionnaire ‘Physical well-being and traumatic experiences (PTE). A separate dental questionnaire determined the effects of previous experiences of pain or force on the emotional self-assessment of the patients (pain localization and body feeling). The TMD group was significantly more likely to have experienced an accident and an illness before the age of 16 years than were the other two groups (PDI/SOP and CG) (P<0·039). Temporomandibular disorder and PDI/SOP patients suffered frequent backaches significantly more than CG patients (P<0·028). The PDI/SOP patients were least likely to report having felt threatened before or after the age of 16 years (P<0·003) compared with the PDI/SOP and CG group. Sociodemographic parameters, experiencing an accident, previous medical incidents, experiences of force and emotional self-assessment influence the biopsychosocial dynamics that directly influence oro-facial symptoms with psychogenic components. Similar to medical history, age seems to play a decisive role in the manifestation of oro-facial psychic symptoms.

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