Analysis of Temporomandibular Disorders, Bruxism and Well-Being in Patients With Fibromyalgia Syndrome: A Case-Control Study

Objectives: To analyse temporomandibular disorders (TMD), bruxism and well-being in patients with fibromyalgia and compare these outcomes with a control group. Method: Diagnostic criteria for the assessment of TMD, bruxism and well-being were used in a clinic context including patients with fibromyalgia (n = 71) and a control group of healthy subjects (n = 151). Participants completed an online questionnaire measuring temporomandibular pain, headache attributed to TMD, jaw locking, joint sounds, headache to bruxism, potential sleep bruxism, potential awake bruxism, jaw functional limitation scale 8 (JFLS-8), generalised anxiety disorder scale 7, oral health impact profile scale 14, World Health Organization well-being index (WHO-5) and Pittsburgh sleep quality index (PSQI). Results: TMD and bruxism were significantly associated with the type of population (chi(2) = 8.77-57.62; p < 0.05; ES = 0.20-0.51). Fibromyalgia patients showed higher prevalence (% values) than control group in temporomandibular pain, headache attributed to TMD, jaw locking, headache attributed to potential bruxism, sleep bruxism and awake bruxism. However, there was a greater prevalence of joint sounds in the control group compared to the fibromyalgia group. Also, fibromyalgia patients scored significantly higher (p < 0.001) on JFLS-8, GAD-7, OHIP-14 and PSQI with a large effect size (ES = 0.51-0.73), while WHO-5 scores were significantly lower (ES = 0.58). Conclusion: Patients with fibromyalgia had greater prevalence than the control group in TMJ pain, headache attributed to TMD, jaw locking, headache attributed to bruxism, sleep bruxism and awake bruxism. Another main finding was that patients with fibromyalgia had greater jaw functional limitation, generalised anxiety and impact of oral health on an individual's life. In addition, fibromyalgia patients showed lower sleep quality and well-being index.