Skip to main content
Journal cover image

Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies.

Publication ,  Journal Article
Slade, GD; Ohrbach, R; Greenspan, JD; Fillingim, RB; Bair, E; Sanders, AE; Dubner, R; Diatchenko, L; Meloto, CB; Smith, S; Maixner, W
Published in: J Dent Res
September 2016

In 2006, the OPPERA project (Orofacial Pain: Prospective Evaluation and Risk Assessment) set out to identify risk factors for development of painful temporomandibular disorder (TMD). A decade later, this review summarizes its key findings. At 4 US study sites, OPPERA recruited and examined 3,258 community-based TMD-free adults assessing genetic and phenotypic measures of biological, psychosocial, clinical, and health status characteristics. During follow-up, 4% of participants per annum developed clinically verified TMD, although that was a "symptom iceberg" when compared with the 19% annual rate of facial pain symptoms. The most influential predictors of clinical TMD were simple checklists of comorbid health conditions and nonpainful orofacial symptoms. Self-reports of jaw parafunction were markedly stronger predictors than corresponding examiner assessments. The strongest psychosocial predictor was frequency of somatic symptoms, although not somatic reactivity. Pressure pain thresholds measured at cranial sites only weakly predicted incident TMD yet were strongly associated with chronic TMD, cross-sectionally, in OPPERA's separate case-control study. The puzzle was resolved in OPPERA's nested case-control study where repeated measures of pressure pain thresholds revealed fluctuation that coincided with TMD's onset, persistence, and recovery but did not predict its incidence. The nested case-control study likewise furnished novel evidence that deteriorating sleep quality predicted TMD incidence. Three hundred genes were investigated, implicating 6 single-nucleotide polymorphisms (SNPs) as risk factors for chronic TMD, while another 6 SNPs were associated with intermediate phenotypes for TMD. One study identified a serotonergic pathway in which multiple SNPs influenced risk of chronic TMD. Two other studies investigating gene-environment interactions found that effects of stress on pain were modified by variation in the gene encoding catechol O-methyltransferase. Lessons learned from OPPERA have verified some implicated risk factors for TMD and refuted others, redirecting our thinking. Now it is time to apply those lessons to studies investigating treatment and prevention of TMD.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Dent Res

DOI

EISSN

1544-0591

Publication Date

September 2016

Volume

95

Issue

10

Start / End Page

1084 / 1092

Location

United States

Related Subject Headings

  • United States
  • Temporomandibular Joint Disorders
  • Risk Factors
  • Risk Assessment
  • Polymorphism, Single Nucleotide
  • Phenotype
  • Pain Measurement
  • Humans
  • Genotype
  • Gene-Environment Interaction
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Slade, G. D., Ohrbach, R., Greenspan, J. D., Fillingim, R. B., Bair, E., Sanders, A. E., … Maixner, W. (2016). Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies. J Dent Res, 95(10), 1084–1092. https://doi.org/10.1177/0022034516653743
Slade, G. D., R. Ohrbach, J. D. Greenspan, R. B. Fillingim, E. Bair, A. E. Sanders, R. Dubner, et al. “Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies.J Dent Res 95, no. 10 (September 2016): 1084–92. https://doi.org/10.1177/0022034516653743.
Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, et al. Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies. J Dent Res. 2016 Sep;95(10):1084–92.
Slade, G. D., et al. “Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies.J Dent Res, vol. 95, no. 10, Sept. 2016, pp. 1084–92. Pubmed, doi:10.1177/0022034516653743.
Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, Dubner R, Diatchenko L, Meloto CB, Smith S, Maixner W. Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies. J Dent Res. 2016 Sep;95(10):1084–1092.
Journal cover image

Published In

J Dent Res

DOI

EISSN

1544-0591

Publication Date

September 2016

Volume

95

Issue

10

Start / End Page

1084 / 1092

Location

United States

Related Subject Headings

  • United States
  • Temporomandibular Joint Disorders
  • Risk Factors
  • Risk Assessment
  • Polymorphism, Single Nucleotide
  • Phenotype
  • Pain Measurement
  • Humans
  • Genotype
  • Gene-Environment Interaction