Myofascial pain-dysfunction: subjective signs and symptoms

Dental patients were classified by experienced dentists as MPD or non-MPD patients. Apart from the symptoms often used as criteria for such a classification, there is a broad range of symptoms and patient characteristics associated with MPD. Because of procedural and methodologic problems, little is known about the strength of these associations. Because reliable knowledge about symptoms and characteristics of MPD is needed for MPD etiology and for adequate treatment evaluation, the present study tried to establish which subjective signs and symptoms differentiate MPD from non-MPD patients. Results of a questionnaire show that 10 items classified 86% of the patients correctly. Among them, restricted mouth opening and sounds at jaw movement had the highest discriminative power. Pain in the jaw area also showed a highly significant difference between the patient groups. When patient selection is based on these criteria, approximately the same patient groups are obtained by a time-consuming dental examination and by a low-cost questionnaire. Results also showed that reported oral habits such as chewing on hard or tough objects and lip-tongue-cheek biting do not differentiate the two groups. Symptoms related to ears and eyes discriminate the groups only marginally. Sleep-related symptoms, with awakening with stiff or painful jaws as the most important item, differentiate patients in a more substantial way. The suggestion from a great number of studies that stress and tension are etiologic factors in MPD is not supported by the present results.(ABSTRACT TRUNCATED AT 250 WORDS)