Dr. Adams' Alabama Headache Blog

Thirty one consecutive patients, attending the Gelb TMD Orofacial Pain Center, who had recieved at least three months of biteplate treatment were administered a second SCL-90 and 10-point Visual Analog Pain Scale. 30 females and 1 male comprised the patient. 50 non-patient controls were recruited from the students and staff of tufts Dental School. Over the period of treatment, general pain level reduced significantly(Wilcoxon Signed Rank Test [WSRT]) from a median of 6 pre-treatment to a median of 3 after the treatment period. During the same period pain pre-, median=2.01, was no different from pain post, median=1.6. WSRTs showed that with the exception of Phobia, scores on all dimensions decreased significantly: 1) Somatization, p=0.03, 2) Obsessive Compulsive p=0.007, 3) Interpersonal Sensitivity, p=0.003, 4) Depression, p=0.015, 5) Anxiety, p=0.001, 6)Hostility, p=0.018, 7) Paranoia, p=0.038, 8)Psychiticism, p=0.02. For controls, there was no differnece between pre- and post- treatment scores on all dimensions decreased significantly. TMD patients were then divided into pretreatment high pain (greater than 5) and low pain (5 and lower) groups of 18 and 13 respectively. Both groups reported a significant reduction in pain from the start of therapy: High pain p=0.0002 and low pain 0.0185. WSRTs performed on the scores of low patients showed a significant reduction in only the Hostility scores, p=0.0145. Somatization, Hostility, and Paranoia. Selecting specific items of the Somatization dimension responses of the group of 31 patients showed significant reduction in the headache item (p=0.0157), the muscle pain item (p=0.002), the numbness item (p=0.0157) and the back pain item (p=0.033). Biteplate therapy for TMD reduces reported stress levels significantly in 9 of 10 dimensions of the SCL-90. Analysis of the high pain patients indicates that the greater reduction in these patients may overshadow the smaller changes of the low pain group.