Painful temporomandibular disorders (TMD) and comorbidities in primary care: associations with pain-related disability.

OBJECTIVE: We studied whether primary care temporomandibular disorder (TMD) patients reporting different levels of pain-related disability differ in terms of comorbid pains, general health conditions and quality of life.

MATERIAL AND METHODS: Consecutive TMD pain patients (n = 399) seeking treatment in primary care completed a questionnaire on comorbid pains and their interference and the Finnish version of the RAND-36-item quality of life questionnaire. Medical diagnoses confirmed by doctors were recorded. The patients were classified according to the Graded Chronic Pain Scale (GCPS) of the Research Diagnostic Criteria for TMD (RDC/TMD). The patients were classified: no disability group (0 disability points), low disability group (1-2 disability points) and high disability group (3-6 disability points).

RESULTS: Compared to patients in the no-disability group, patients in the high- and low-disability groups reported more comorbid pain conditions (p < .001), and experienced these as more intense and interfering more with daily life (p < .05). Patients in the high-disability group reported more general health-related medical diagnoses than patients in the no-disability group (p < .05). Furthermore, patients with low or high pain-related disability indicated poorer quality of life in all RAND-36 subscales than those with no disability (p < .05).

CONCLUSIONS: The findings suggest that GCPS-related disability scoring can be used as a simple screening instrument to identify TMD patients with different degrees of health burdens.