Researchers from University of Bari in Italy investigated the prevalence of craniomandibular disorders (CMD) among fibromyalgia (FM) patients and the impact it has on their quality of life.  The study entitled “Quality of life in fibromyalgia patients with craniomandibular disorders” was recently published in The Open Dentistry Journal.

FM is a chronic condition associated with widespread pain of unknown origin in muscles and joints. FM affects approximately 2% to 5% of the US population. The American College of Rheumatology (ACR) criteria for a diagnosis of FM consists of the patient having severe widespread pain symptoms that have been chronically present for 3 months or greater without a known cause. FM often occurs with other pain-inducing conditions such as CMD.

CMD defines an array of conditions that involve the masticatory muscles (MM), the temporomandibular (TM) joints and other associated anatomical structures that are used to chew, as well as the opening and closing of a patient’s mouth.  Patients usually have symptoms such as headaches, neck aches, face pain, ear ache and tinnitus that may be accompanied by hearing loss.

The purpose of this study was to determine the prevalence of CMD among a subset of hospital patients already diagnosed with FM; with a focus on the impact the comorbidities had on the subject’s quality of life.

To be part of the study, potential subjects had to meet the following inclusion criteria: a diagnosis of FM, a willingness to undergo an oral and mastication exam (also known as a gnatologic assessment), and fill out a survey that included questions on demographic information and quality of life assessments.

The study population consisted of 31 patients, 28 females (90.3%), and  3 males (9.7%), their ages ranged from 20 to 65 years with an average age of 47.9 years.

Key Pain Findings:

• In 25 FM patients (80.6%) the signs and symptoms of CMD were observed.
• 18 patients (58.1%) reported a daily pain frequency, 11 (35.5%) a weekly frequency, and 2 (6.4%) a monthly frequency.
• The average pain duration, at the time patients were enrolled, was about 8 months.
• A muscular disorder was found to be present in 21 patients (84%), a disc dislocation in 11 patients (44%), inflammatory and degenerative joint disorders in 3 patients (12%).
• In 40% of cases there was a combined muscular degenerative diagnosis.

The major study finding was that there is a not a statistically significant difference in quality of life scores for FM patients with CMD in comparison to those without.  The study authors contributed this finding to the possibility that patients with FM are already so burdened by their condition that the introduction of an additional pain condition (like the masticatory muscle pain found in the study population), does not affect their health related quality of life.

The results of this study add to the body of knowledge suggesting that CMD is highly prevalent among the FM patient population.  These are important findings for healthcare providers and dentists who care for FM patients, so that they may better understand the potential implications these comorbid conditions may have on their patient’s quality of life.