Presence of orofacial pain and temporomandibular disorder in fibromyalgia. A study by questionnaire.

The objective of this study was to evaluate subjective symptoms from the temporomandibular system in patients with fibromyalgia. Two hundred and thirty-seven individuals with fibromyalgia affiliated to the Stockholm Rheumatologic Association were included in the study. A questionnaire about symptoms of temporomandibular disorders (TMD) was mailed and returned by 191 (81%). The participants reported frequent and severe symptoms of TMD, 94% reported local pain from the temporomandibular system with a mean duration of 12 years. The most frequent sites were the temple, temporomandibular joint and neck regions. General body pain had a significantly longer duration than TMD, which indicates that fibromyalgia starts in other parts of the body and later extends to the temporomandibular region. The severity of general pain scored significantly higher than local pain, but there was a significant positive correlation between the two conditions. High frequency, 73-78 %, of headache, facial pain and tiredness of the jaws was found and about fifty percent of the patients also complained about difficulties to open the mouth and to chew. Fibromyalgia is thus a probable cause of TMD. In conclusion this study shows that patients with fibromyalgia often suffer from symptoms of TMD, and that the intensity of the pain is correlated to general body pain. These findings indicate that fibromyalgia is one of the causes of TMD.