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Behavioral Intervention in Pain Related Problems in Dentistry

  • Chapter
The Comprehensive Handbook of Behavioral Medicine

Abstract

Dentistry has long been concerned with the treatment of pain-related disorders and has traditionally relied upon pharmacological agents and surgical and dental procedures to achieve pain relief (4). Although often adequate for the amelioration of many acute and chronic pain conditions, traditional dental interventions frequently have been ineffective in reducing or eliminating some pain and pain behaviors, e.g., those associated with temporomandibular joint pain and dysfunctional disorder (TMJ disorder) (4, 61). Researchers have long recognized the emotional components of these disorders (71, 72, 79), and recent work by Fordyce (26) has suggested that some typical aspects of pain and pain behavior may be learned, which implies that behavioral approaches may be useful in treating this type of pain. This chapter discusses the application of behavioral intervention strategies to modifying pain-related problems, such as TMJ disorder and bruxism in dentistry.

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References

  1. Ackerman, J. B. A new approach to the treatment of bruxism and bruxomania. N. Y. S. Dent. J. 32:259, 1966.

    CAS  Google Scholar 

  2. Agerberg, G., and Carlsson, G. E. Functional disorders of the masticatory system: I Distribution of symptoms according to age and sex. Acta Odontol Scand.30:597, 1972.

    PubMed  CAS  Google Scholar 

  3. Alderman, M. M. Disorders of the temporomandibular joint and related structures. Rationale for diagnosis, etiology, management. Alpha Omegan 12 December 1976.

    Google Scholar 

  4. Alling, C. C., and Mahan, P. E. (eds.). Facial Pain. Philadelphia: Lea & Febiger, 1977.

    Google Scholar 

  5. Ayer, W. A., and Gale, E. N. Extinction of bruxism by massed practice therapy. J. Can. Dent. Assoc. 35:492, 1969.

    PubMed  CAS  Google Scholar 

  6. Ayer, W. A., and Hirschman, R. D. (eds.). Psychology and Dentistry: Selected Readings. Springfield, Ill.: Charles Thomas, 1972.

    Google Scholar 

  7. Ayer, W. A., and Levin, M. P. Elimination of tooth grinding habits by massed practice therapy.J. Periodontol. 44:569, 1973.

    PubMed  CAS  Google Scholar 

  8. Ayer, W. A., and Levin, M. P. Theoretical bases and application of massed practice exercises for the elimination of tooth grinding habits.J. Periodontol. 46:306, 1975.

    PubMed  CAS  Google Scholar 

  9. Basmajian, J. V. Control of individual motor units. Am. J. Phys. Med. 46:480, 1967.

    PubMed  CAS  Google Scholar 

  10. Beecher, H. K. Anxiety and pain. JAMA 209:1080, 1969.

    PubMed  CAS  Google Scholar 

  11. Bessett, R., Bishop, B., and Mohl, N. Duration of masseteric silent period in patients with TMJ syndrome.J. Appl. Physiol. 30:864, 1971.

    Google Scholar 

  12. Blanchard, H. B., and Young, L. D. Clinical applications of biofeedback training. Arch. Gen. Psychiatry 30:573, 1974.

    PubMed  CAS  Google Scholar 

  13. Bonica, J. J. Management of pain: The development of modern approaches, in C. C. Alling and P. E. Mahan (eds.), Facial Pain. Philadelphia: Lea & Febiger, 1977.

    Google Scholar 

  14. Budzynski, T., and Stoyva, J. An electromyographic feedback technique for teaching voluntary relaxation of the masseter muscle. J. Dent. Res. 52:116, 1973.

    Google Scholar 

  15. Budzynski, T., Stoyva, J., Adler, C. S., and Mullaney, D. J. EMG biofeedback and tension headache: A controlled outcome study. Psychosom. Med. 35:484, 1973.

    PubMed  CAS  Google Scholar 

  16. Cameron, D. E. Observations on the patterns of anxiety. Am. J. Psychiatry 101:36, 1944.

    Google Scholar 

  17. Carlsson, S. G., and Gale, E. N. Biofeedback treatment for muscle pain associated with the temporomandibular joint.J. Behav. Ther. and Exper. Psychiat. 7:383, 1976.

    Google Scholar 

  18. Carlsson, S. G., and Gale, E. N. Biofeedback in the treatment of long-term temporomandibular joint pain. Biofeedback and Self-Regulation 2:161, 1977.

    PubMed  CAS  Google Scholar 

  19. Carlsson, S. G., Gale, E. N., and Ohman, A. Treatment of temporomandibular joint syndrome with biofeedback training.J. Am. Dent. Assoc. 91:602, 1975.

    PubMed  CAS  Google Scholar 

  20. Chasins, A. I. Methocarbamal (Robaxin) as an adjunct in the treatment of bruxism.J. Dent. Med. 14:166, 1959.

    Google Scholar 

  21. Clarke, N. G., and Kardachi, B. J. The treatment of myofascial pain-dysfunction syndrome using the biofeedback principle.J. Periodontol. 48:643, 1977.

    PubMed  CAS  Google Scholar 

  22. Costen, J. B. A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. Ann. Otal. 43:1, 1934.

    Google Scholar 

  23. Dohrmann, R. J., and Laskin, D. M. Treatment of myofascial pain dysfunction syndrome with EMG biofeedback. J. Dent. Res. Special Issue B, B249, 1976.

    Google Scholar 

  24. Eschler, J. Bruxism and function of the masticatory muscles. Parodontologie 15, 16:109, 1961.

    Google Scholar 

  25. Evaskus, D. S., and Laskin, D. M. A biochemical measure of stress in patients with myofascial pain dysfunction syndrome. J. Dent. Res. 51:33, 1972.

    Google Scholar 

  26. Fordyce, W. Behavioral Methods for Chronic Pain and Illness. St. Louis: C. V. Mosby, 1976.

    Google Scholar 

  27. Forgione, A. G. Psychological treatments of nocturnal bruxism. Paper presented at 84th Annual Convention of the American Psychological Association, Washington, D. C., 1976.

    Google Scholar 

  28. Frisch, J., Katz, L., and Ferreira, A. J. A study on the relationship between bruxism and aggression.J. Periodontol. 31:409, 1960.

    Google Scholar 

  29. Frost, H. M. Musculoskeletal pain, in C. C. Alling and P. E. Mahan (eds.), Facial Pain. Philadelphia: Lea & Febiger, 1977, p. 135.

    Google Scholar 

  30. Gessel, A. H. Electromyographic biofeedback and tricyclic anti-depressants in myofascial pain-dysfunction syndrome: Psychological predictors of outcome. J. Am. Dent. Assoc. 91:1048, 1975.

    PubMed  CAS  Google Scholar 

  31. Gessel, A. H., and Alderman, M. M. Management of myofascial pain dysfunction syndrome of the temporomandibular joint by tension control training. Psychosomatics 12:302, 1971.

    PubMed  CAS  Google Scholar 

  32. Glaros, A. G., and Rao, S. M. Bruxism: A critical review. Psychol. Bull. 84:767, 1977.

    PubMed  CAS  Google Scholar 

  33. Glaros, A. G., and Rao, S. M. Effects of bruxism: A review of the literature. J. Prosthet. Dent., in press.

    Google Scholar 

  34. Gold, S., Lipton, J., Marbach, J., and Gurion, B. Sites of psychophysiological complaints in MPD patients: II. Areas remote from the orofacial region. J. Dent. Res. Special Issue A, 54, abstract 480, 1975.

    Google Scholar 

  35. Goldberg, G. The psychological, physiological and hypnotic approach to bruxism in the treatment of periodontal disease.J. Am. Soc. Psychosomat. Dent. Med. 20:75, 1973.

    CAS  Google Scholar 

  36. Goldstein, I. B. Physiological responses in anxious women patients. Arch. Gen. Psychiatry 10:382, 1964.

    PubMed  CAS  Google Scholar 

  37. Goodman, P., and Greene, C. S. Response to placebo equilibration in MPD patients. J. Dent Res. Special Issue B, 52, 72, 1973.

    Google Scholar 

  38. Greene, C. S. The relationship between research and clinical practice in treatment of myofascial pain-dysfunction. Alpha Omegan 18 December 1976.

    Google Scholar 

  39. Greene, C. S., and Laskin, D. M. Splint therapy for the myofascial pain-dysfunction (MPD) syndrome: A comparative study. J. Am Dent. Assoc. 84:624, 1972.

    PubMed  CAS  Google Scholar 

  40. Greene, C. S., and Laskin, D. M. Long-term evaluation of conservative treatment for myofascial pain-dysfunction syndrome. J. Am. Dent. Assoc. 89:1365, 1974.

    PubMed  CAS  Google Scholar 

  41. Greene, C. S., Lerman, M. D., Sutcher, H. D., and Laskin, D. M. The TMJ pain-dysfunction syndrome: Heterogeneity of the patient population. J. Am. Dent. Assoc. 79:1168, 1969.

    PubMed  CAS  Google Scholar 

  42. Greene, C. S., and Markovic, M. Response to nonsurgical treatment of patients with positive radiographic findings in the temporomandibular joint. J. Oral Surg. 34:692, 1976.

    PubMed  CAS  Google Scholar 

  43. Grieder, A. Psychologic aspects of prosthodontics. J. Prosthet. Dent. 30:736, 1973.

    PubMed  CAS  Google Scholar 

  44. Heller, R. F., and Forgione, A. G. An evaluation of bruxism control: Massed negative practice and automated relaxation training. J. Dent. Res. 54:1120, 1975.

    PubMed  CAS  Google Scholar 

  45. Heller, R. F., and Strang, H. R. Controlling bruxism through automated aversive conditioning. Behav. Res. and Ther. 11:327, 1973.

    CAS  Google Scholar 

  46. Hersen, M., and Eisler, R. Social skills training, in E. Craighead, A. Kazdin, and M. Mahoney (eds.), Behavior Modification: Principles, Issues and Applications. Boston: Houghton Mifflin Co., 1976.

    Google Scholar 

  47. Husted, E. Surgical methods, in L. Schwartz and L. M. Chayes (eds.), Facial Pain and Mandibular Dysfunction. Philadelphia: Saunders, 1968.

    Google Scholar 

  48. Jarabak, J. R. An electromyographic analysis of muscular and temporomandibular joint and adjacent muscles. J. Dent. Res. 39:750, 1960.

    Google Scholar 

  49. Kardachi, B. J., and Clarke, N. G. The use of biofeedback to control bruxism. J. Periodontol. 48:639, 1977.

    PubMed  CAS  Google Scholar 

  50. Kraus, H. T. Muscle function and the temporomandibular joint. J. Prosth. Dent. 13:950, 1963.

    Google Scholar 

  51. Kraus, H. Physical methods, in L. Schwartz and L. M. Chayes (eds.), Facial Pain and Mandibular Dysfunction. Philadelphia: Saunders, 1968.

    Google Scholar 

  52. Krell, M., and Laskin, D. M. Measurement of masseteric silent period for diagnosis and treatment evaluation in MPD syndrome. J. Dent. Res. Special Issue B, 56, 38, 1977.

    Google Scholar 

  53. Kydd, W. L. Psychosomatic aspects of temporomandibular joint dysfunction. J. Am. Dent. Assoc. 59:31, 1959.

    PubMed  CAS  Google Scholar 

  54. Laskin, D. M. Etiology of the pain-dysfunction syndrome. J. Am. Dent. Assoc. 79:147, 1969.

    PubMed  CAS  Google Scholar 

  55. Laskin, D. M., and Greene, C. S. Influence of the doctor-patient relationship on placebo therapy for patients with myofascial pain-dysfunction (MPD) syndrome. J. Am. Dent. Assoc. 85:892, 1972.

    PubMed  CAS  Google Scholar 

  56. Lerman, M. D. A unifying concept of the TMJ pain-dysfunction syndrome. J. Am. Dent. Assoc. 83:833, 1973.

    Google Scholar 

  57. Linquist, B. Bruxism in children. Odont. Rev. 22:413, 1971.

    Google Scholar 

  58. Lupton, D. E. Psychological aspects of the temporomandibular joint dysfunction. J. Am. Dent. Assoc. 79:131, 1969.

    PubMed  CAS  Google Scholar 

  59. Lupton, D. E., and Johnson, D. L. Myofascial pain-dysfunction syndrome: Attitudes and other personality characteristics related to tolerance for pain. J. Prosth. Dent. 29:323, 1973.

    CAS  Google Scholar 

  60. Malmo, R. B. Anxiety and behavioral arousal. Psychol. Rev. 64:276, 1957.

    PubMed  CAS  Google Scholar 

  61. Marbach, J. J. A holistic approach to the treatment of facial pain. Alpha Omegan 32 December 1976.

    Google Scholar 

  62. McCall, C. M., Szmyd, L., and Ritter, R. M. Personality characteristics in patients with TMJ symptoms. J. Am. Dent. Assoc. 62:694, 1961.

    PubMed  Google Scholar 

  63. Mealiea, W. L. Behavioral sciences contribution to the assessment and treatment of myofascial pain. Presented at 94th Annual Scientific Session, Florida Dental Association, Hollywood, Florida, May 1977.

    Google Scholar 

  64. Meklas, J. F. Bruxism: Diagnosis and treatment. J. Acad. Gen. Dent. 19:31, 1971.

    PubMed  CAS  Google Scholar 

  65. Melzack, R. Psychological concepts and methods for the control of pain, in J. J. Bonica (ed.), Advances in Neurology: International Symposium on Pain. New York: Raven Press, 1974, p. 275.

    Google Scholar 

  66. Melzack, R., and Wall, P. D. Pain mechanisms: A new theory. Science 150:971, 1965.

    PubMed  CAS  Google Scholar 

  67. Mercuri, L. G., and Laskin, D. M. Masticatory muscle response specificity to stressful stimuli in MPD syndrome. IADR Abstract #557.

    Google Scholar 

  68. Miller, N. E. Learning of visceral and glandular response. Science 163:434, 1969.

    PubMed  CAS  Google Scholar 

  69. Molin, C. Studies in mandibular pain dysfunction syndrome. Swedish Dent. J. 66:7, 1973.

    Google Scholar 

  70. Moore, D. S. Bruxism diagnosis and treatment. J. Periodontol. 27:277, 1956.

    Google Scholar 

  71. Moulton, R. E. Oral and dental manifestations of anxiety. Psychiatry 18:261, 1955.

    PubMed  CAS  Google Scholar 

  72. Moulton, R. E. Emotional factors in non-organic temporomandibular joint pain. Dent. Clin. North Am. 10:609, 1966.

    Google Scholar 

  73. Moulton, R. E. Emotional factors in non-organic temporomandibular joint pain, in L. Schwartz and L. M. Chayes (eds.), Facial Pain and Mandibular Dysfunction. Philadelphia: Saunders, 1968.

    Google Scholar 

  74. Olson, R. E. Biofeedback for MPD patients nonresponsive to drug and biteplate therapy. J. Dent. Res. Special Issue B, 56, B40, 1977.

    Google Scholar 

  75. Pearlman, I., and Laskin, D. M. Double-blind evaluation of anesthetic injections in differential diagnosis of joint and muscle pain in MPD syndrome. IADR, Abstract #197, 1974.

    Google Scholar 

  76. Peck, C.L., and Kraft, G. Electromyographic biofeedback for pain related to muscle tension. Arch. Surg. 112:889, 1977.

    PubMed  CAS  Google Scholar 

  77. Perry, H. T. Muscular changes associated with temporomandibular joint dysfunction. J. Am. Dent. Assoc. 54:644, 1957.

    Google Scholar 

  78. Petrie, A. Individuality in Pain and Suffering. Chicago: University of Chicago Press, 1967.

    Google Scholar 

  79. Phillips, C. A psychological analysis of tension headache, in S. Rachman (ed.), Contributions to Medical Psychology. Oxford: Pergamon Press, 1977.

    Google Scholar 

  80. Pilling, L. F. Psychosomatic aspects of facial pain, in C. C. Alling and P. E. Mahan(ed.), Facial Pain. Philadelphia: Lea & Febiger, 1977, p. 213.

    Google Scholar 

  81. Powell, R. N. Tooth contact during sleep: Association with other events. J. Dent. Res. 44:959, 1965.

    PubMed  CAS  Google Scholar 

  82. Ramfjord, S. Bruxism, a clinical and electromyographic study. J. Am. Dent. Assoc. 62:21, 1961.

    PubMed  CAS  Google Scholar 

  83. Ramfjord, S. P., and Ash, M. M. Occlusion. Philadelphia: W. B. Saunders Co., 1966.

    Google Scholar 

  84. Ramfjord, S. P., and Ash, M. M. Occlusion, 2nd Ed. Philadelphia: W. B. Saunders Co., 1971.

    Google Scholar 

  85. Reding, G. R. Incidence of bruxism. J. Dent. Res. 45:1198, 1966.

    PubMed  CAS  Google Scholar 

  86. Reding, G. R., Zepelin, H., and Monroe, L. J. Personality study of nocturnal teeth-grinding. Percept. Mot. Skills 26:523, 1968.

    PubMed  CAS  Google Scholar 

  87. Reding, G. R., Zepelin, H., Robinson, J. E., Zimmerman, S. O., and Smith, V. H. Nocturnal teeth-grinding: All night psychophysiological studies. J. Dent. Res. 47:786, 1968.

    PubMed  CAS  Google Scholar 

  88. Rugh, J. D., and Solberg, W. K. Electromyographic studies of bruxist behavior before and during treatment. J. Calif. Dent. Assoc. 3:56, 1975.

    PubMed  CAS  Google Scholar 

  89. Rugh, J. D., and Solberg, W. K. Psychological implications in temporomandibular pain and dysfunction. Oral Sci. Rev. 7:3, 1976.

    PubMed  CAS  Google Scholar 

  90. Satch, Y., and Haroda, Y. Electrophysiological study on tooth grinding during sleep. Electroenceph. Clin. Neurophysiol. 35:267, 1973.

    Google Scholar 

  91. Schwartz, L. A temporomandibular joint pain-dysfunction syndrome. J. Chron. Dis. 3:284, 1956.

    PubMed  CAS  Google Scholar 

  92. Schwartz, L. Conclusions of the temporomandibular joint clinic at Columbia. J. Periodontol. 29:210, 1958.

    Google Scholar 

  93. Schwartz, L. Disorders of the Temporomandibular Joint. Philadelphia: W. B. Saunders Co., 1959.

    Google Scholar 

  94. Schwartz, L., and Chayes, L. M. Facial Pain and Mandibular Dysfunction. Philadelphia: W. B. Saunders Co., 1958.

    Google Scholar 

  95. Schwartz, R. A. Personality characteristics of unsuccessfully treated MPD patients. J. Dent. Res. Special Issue, 53, 291, 1974.

    Google Scholar 

  96. Shapiro, S., and Shanon, J. Bruxism as an emotional reactive disturbance. Psychosoma. 6:427, 1965.

    CAS  Google Scholar 

  97. Shipman, W. G. Analysis of MMPI test results in women with MPD syndrome. J. Dent. Res. Special Issue, 82, 79, 1973.

    Google Scholar 

  98. Shipman, W. G., Greene, C. S., and Laskin, D. M. Correlation of placebo responses and personality characteristics in myofascial pain-dysfunction (MPD) patients. J. Psychosom. Res. 18:475, 1974.

    PubMed  CAS  Google Scholar 

  99. Skiba, T. J., and Laskin, D. M. Masticatory muscle silent period in patients with MPD syndrome. J. Dent. Res. Special Issue B, 55, 748, 1976.

    Google Scholar 

  100. Solberg, W. K., Flint, R. T., and Brantner, J. P. Temporomandibular joint pain and dysfunction: A clincial study of emotional and occlusal components. J. Prosthet. Dent. 28:412, 1972.

    PubMed  CAS  Google Scholar 

  101. Solberg, W. K., and Rugh, J. D. The use of biofeedback devices in the treatment of bruxism. J. South. Calif. Dent. Assoc. 40:852, 1972.

    PubMed  CAS  Google Scholar 

  102. Sternbach, R. A. Pain: A Psychophysiological Analysis. New York: Academic Press, 1968.

    Google Scholar 

  103. Sternbach, R. A. Pain Patients, Traits and Treatment. New York: Academic Press, 1974.

    Google Scholar 

  104. Thaller, J. Bruxism, a factor in periodontal disease. N. Y. S. Dent. J. 31:17, 1965.

    CAS  Google Scholar 

  105. Thomas, L., Tiber, N., and Schireson, S. The effects of anxiety and frustration on the masseter tension related to the TMJ syndrome. Oral Surg., Oral Med., Oral Path. 36:763, 1973.

    CAS  Google Scholar 

  106. Vestergaard-Christensen, L. Facial pain and internal pressure of masseter muscle in experimental bruxism in man. Arch. Oral Biol. 9:1021, 1971.

    Google Scholar 

  107. Williams, W. N., LaPointe, L. L., and Thornby, J. I. Interdental thickness discrimination by normal subjects. J. Dent Res. 53:1404, 1974.

    PubMed  CAS  Google Scholar 

  108. Wolpe, J., and Lazarus, A. Behavior Therapy Techniques. New York: Pergamon Press, 1966.

    Google Scholar 

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Authors
  1. Barbara G. Melamed
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  2. Wallace L. Mealiea Jr.
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Editors and Affiliations

  1. Gifford Mental Health Center, USA

    James M. Ferguson M.D. (Medical Director, Assistant Professor of Psychiatry) (Medical Director, Assistant Professor of Psychiatry)

  2. San Diego School of Medicine, University of California, USA

    James M. Ferguson M.D. (Medical Director, Assistant Professor of Psychiatry) (Medical Director, Assistant Professor of Psychiatry)

  3. Department of Psychiatry, VA Hospital, La Jolla, USA

    James M. Ferguson M.D. (Medical Director, Assistant Professor of Psychiatry) (Medical Director, Assistant Professor of Psychiatry)

  4. Stanford University Medical Center, Stanford, California, USA

    C. Barr Taylor M.D. (Assistant Professor of Psychiatry) (Assistant Professor of Psychiatry)

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Melamed, B.G., Mealiea, W.L. (1981). Behavioral Intervention in Pain Related Problems in Dentistry. In: Ferguson, J.M., Taylor, C.B. (eds) The Comprehensive Handbook of Behavioral Medicine. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-7280-6_13

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  • DOI: https://doi.org/10.1007/978-94-011-7280-6_13

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