A NEW APPROACH FOR PAIN IN TEMPOROMANDIBULAR DISORDERS ADDRESSING THE INTERACTION OF DIET, EATING HABITS AND MEDICATIONS

Background:Temporo-mandibular disorders (TMDs) is an umbrella term to describe a condition with a multifactorial etiology characterized by various symptoms including:limitations on opening the mouth, clicking or grinding, orofacial pain, referred muscular pain or headaches.Pain has many origins, such as muscular, neuropathic, or vascular. It is the most frequent symptom, and often limits the patient's daily habits. In the presence of orofacial pain in temporomandibular disorders some functions such as eating, talking, or singing are limited and there are foods that can improve or worsen the symptoms. The patient, in the presence of pain, often has to resort to medications. Even today, this pathology, although quite widespread, does not have precise guidelines for therapy. In addition, the literature is still not clear about the most appropriate types of therapy as muscle pain and neuropathic pain are usually co-present with TMD. Therapy depends upon correctly identifying the etiology, for the treatment or the management of symptoms to be successful and to improve quality of life. Aim:The aim of this study was to evaluate, through a survey, the correlation between lifestyle (diet, oral habits, medications, pasorthodontic treatments) and temporomandibular disorders (TMDs) and how these two variables interact, in order to counsel the patient with orofacial/TMJ pain on how to best modify their diet/eating habits to reduce the symptoms and modify, if needed, any pharmacological intervention. Materials and Methods:Two hundred and nine (209) patients completed an online survey including questions about their TMD symptoms, their diet, frequency of meals, previous and current orthodontic treatments and most used medications to reduce pain. The questionaries, available in two languages (Italian and English) and composed mostly of yes/no questions, were shared among patients affected by TMDs who were being treated and or had been treated for temporo-mandibular disorders. Results: Our study confirms what we found in the literature, which is an association between frequency of eating and TMJ/orofacial pain. The consistency or texture of frequently consumed foods was also relevant in the severity of pain as patients reported an association between the consumption of hard foods and pain. Among the respondents, NSAIDs and myorelaxants were significantly more effective than supplements and corticosteroids. No statistical correlation was found between orthodontic therapy and a decrease in mouth opening. Conclusions:Food and eating habits seem to have the capacity to affect TMJ/orofacial pain. The role of daily eating habits, should be further investigated. In fact they could represent a new frontier in the management of joint pain as they can be managed directly by the patients, and complement other pain therapy options such as medications and oral devices.