Temporo-mandibular joint dysfunction: Pain and illness behaviour

Abstract

The illness behavior of 100 patients with temporo-mandibular (TMJ) dysfunction and 100 asymptomatic patients was investigated. It has been shown that a simple illness behavior questionnaire (IBQ) can discriminate between patients with intractable facial pain and minor odontogenic pain [28]. The purpose of this study was to determine whether it was possible to prospectively identify those patients who may be resistant to conservative therapy. The results showed that the TMJ dysfunction patients had significantly increased levels of disease conviction (P < 0.001), anxiety or depression (P < 0.005), and were less likely to deny the existence of problems in their life (P < 0.05) compared to control patients. The TMJ population was much closer to the control population than to a pain clinic population. In the small percentage (13%) of patients who failed to respond to conservative therapy. > 1/2 showed abormal illness behavior. Seventy-five of all the TMJ patients could be excluded from further assessment of abnormal ilness behavior at little risk of incorrect classification. Thus the illness behavior questionnaire can be used as a screening device to identify those patients who require psychologic treatment rather than more aggressive surgical treatment.