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Von
Korff (1999)
and Crombie and Davies (1999)
have written about methodologic issues in the epidemiologic study
of pain, especially chronic pain. Some of these issues are generic
to studying symptomatic conditions -- conditions that must be
identified through the self report of the person with the condition
-- and some of these issues arise because of the fluctuating,
recurrent course of many pain problems.
This chapter
will illustrate how these issues play out and can be addressed
in studies of a specific pain condition -- pain associated with
temporomandibular disorders, or TMD.
Definition
of TMD
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Temporomandibular
Disorders are musculoskeletal pain conditions characterized
by pain in the muscles of mastication and/or the temporomandibular
joint (TMJ). TMD pain is frequently (but not universally)
accompanied by one or more of the following signs
and symptoms:
- sounds
in the TMJ on opening or closing the jaw, including
clicking or popping and grating or grinding (crepitus)
- pain
in the muscles or TMJ when these areas are palpated
- limited
ability to open the jaw
- deviation
of the jaw to one side when opening or closing the
mouth
- pain
with chewing or other jaw movements
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