Self-reported ability to concentrate in patients with painful temporomandibular disorders compared to the general population

Objectives This study explored whether patients with painful temporomandibular disorders (TMD) differ from the general population in the frequency of self-reported disability to concentrate, because altered processing of sensory information had been reported previously. Additionally, the correlation of the frequency of concentration problems with the dysfunctional grade of TMD pain shall be evaluated. Methods Subjects were 286 consecutive German patients with painful TMD diagnosed using the Research Diagnostic Criteria (RDC/TMD) and 2026 members of a representative German community sample. Concentration was measured using two questions, one from the 'Oral Health Impact Profile (OHIP-49 G)' and one from the German version of 'Center for Epidemiologic Studies - Depression Scale (CES-D)'. The dysfunctional grade of TMD pain was measured using the Graded Chronic Pain Scale. Results Responses between the two individual questions concerning the ability to concentrate (OHIP item and CES-D item) correlated moderately (r_Spearman = 0.58, P < 0.001). A two-sample test of proportions revealed that patients with TMD pain reported a significantly greater frequency of 'fairly often' or 'very often' occurring concentration problems, 24.0%, than did the general population subjects, 1.2% (P < 0.001). Moreover, the frequency of concentration problems correlated with an increase in dysfunctional pain grade in the patients with TMD pain (tetrachoric correlation coefficient of 0.52, P < 0.001). Conclusions Self-reported frequency of concentration problems is greater in patients with TMD pain than in the general population and is reported at a higher frequency in patients with more severe dysfunctional pain grades. These findings are consistent with the concept that TMD pain is associated with changes in the central processing.