Impact of Estrogen on TMJ Pain
Affecting the quality of life for more than 10 million Americans, temporomandibular disorders (TMDs) are musculoskeletal conditions associated with pain and dysfunction of the temporomandibular joint (TMJ) and muscles of mastication. The pain and dysfunction associated with TMDs are more prevalent among women during reproductive years, suggesting estrogen plays a role in TMD pathophysiology. Studies describe the potential role of hormonal fluctuations as a contributing risk factor for TMD-related pain. Furthermore, evidence suggests estrogen is a prominent hormone, influencing both inflammatory and pain processes.
Which of the following is a risk factor for TMD?
Estrogen can produce inflammation through various mechanisms of action including stimulation of toll-like receptors (TLR) in the immune system, upregulation of voltage-gated sodium channels, expression of estrogen receptors, or due to genetic variations called polymorphism.
Researchers have found estrogen may influence pain receptors, which may highlight the differences between male-female TMD-related pain.
Treatment modalities for patients experiencing TMD-related pain include which of the following?
Although TMD pain varies throughout the menstrual cycle, it is the lowest immediately after menses, due to high estrogen levels.
Research suggests that regardless of type, number of injections, and dosage, botulinum toxin-a appears to be effective for TMJ-related muscle disorders.
The efficacy of all therapeutic options for patients with TMDs is subjective and should be recommended on a case-by-case basis.
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