Disability Weights for Global Burden Estimation of Orofacial Pain

The global burden of orofacial pain (OFP), including temporomandibular disorders (TMDs), has never been estimated due to lacking disability weights (DWs). This is a significant limitation in the World Health Organization's goals for oral health. The present study presents DWs with directions for the development of corresponding health state descriptions. We used general population data on OFP and TMD (n > 180,000) with linked data on health-related quality of life from the Short Form Health Survey (SF-36; n > 110,000). From the SF-36 sum scores, a cumulative DW was mapped, and condition-specific DWs adjusted for common risk factors were calculated. Pain disability and related self-reported clinical characteristics were presented descriptively in a subsample of 300 individuals. In the study sample (n = 26,253, 49.9% women), participants with OFP reported significantly lower scores on the mental and physical components of the SF-36 when compared with pain-free individuals (P < 0.001), as did individuals with TMD as compared with those without TMD (P < 0.001). After adjusting for the presence of common health states, the mean DW was 0.024 (95% CI, 0.011 to 0.038) for OFP and 0.026 (95% CI, 0.016 to 0.038) for TMD. Individuals with higher pain disability reported higher pain intensity as well as increased pain catastrophizing and functional jaw limitations. Our findings demonstrate a feasible solution for estimating DW for OFP and TMD as an important step toward incorporation of these conditions into the Global Burden of Disease study and suggest a greater impact of pain than other common oral diseases. Further efforts are needed to develop lay descriptions and validate DW findings in other populations.