Skip to main content
Top
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 4/2018

01-07-2018 | Original Article

Prevalence of temporomandibular disorders in patients with Hashimoto thyroiditis

Authors: Alina Grozdinska, Elisabeth Hofmann, Matthias Schmid, Ursula Hirschfelder

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Issue 4/2018

Login to get access

Abstract

Objectives

Autoimmune thyroid disease (AITD), also known as Hashimoto thyroiditis (HT), is a degenerative inflammatory disease with high prevalence among women and has been associated with fibromyalgia and widespread chronic pain. The goal was to determine the frequency of temporomandibular disorders (TMD) in patients with HT.

Methods

In all, 119 women (age 19–60 years) were divided into a study (52 women diagnosed with HT) and a control (67 healthy individuals, of which 15 were excluded) group. Serum concentrations of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroglobulin (Tg) and anti-thyroid peroxidase (TPO) antibody levels were measured. The temporomandibular jaw and muscles were examined using the German Society of Functional Diagnostics and Therapy guidelines. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used to assess TMD. Standardized questionnaires, incorporating epidemiological criteria, state and treatment of the thyroid disease, Helkimo Index (HI), and Fonseca Anamnestic Index (FAI), were filled out by all patients.

Results

The two groups did not differ in terms of demographic parameters or mandibular jaw mobility. Significantly higher levels of anti-TPO and anti-Tg were attested in all subjects of the HT group. Markedly elevated prevalence of TMD was found in the HT group. Muscle pain and stiffness were found in 45 (86.5%) subjects of the HT group (p < 0.001), of whom 33 (63.4%) also had disc displacement with reposition (p < 0.001). Whereas 50% of the control group showed no TMD symptoms, all subjects in the HT group had symptoms.

Conclusions

A significantly elevated prevalence of TMD was found in patients with HT. Thus, patients with TMD who do not respond to therapy should be referred for thyroid diagnostic workup.
Literature
1.
go back to reference Agerberg G, Helkimo M (1987) Symptomatology of patients referred for mandibular dysfunction: evaluation with the aid of a questionnaire. Cranio 5(2):157–163CrossRefPubMed Agerberg G, Helkimo M (1987) Symptomatology of patients referred for mandibular dysfunction: evaluation with the aid of a questionnaire. Cranio 5(2):157–163CrossRefPubMed
2.
go back to reference Ahmad J, Blumen H, Tagoe CE (2015) Association of antithyroid peroxidase antibody with fibromyalgia in rheumatoid arthritis. Rheumatol Int 35(8):1415–1421CrossRefPubMed Ahmad J, Blumen H, Tagoe CE (2015) Association of antithyroid peroxidase antibody with fibromyalgia in rheumatoid arthritis. Rheumatol Int 35(8):1415–1421CrossRefPubMed
3.
go back to reference Ahmad J, Tagoe CE (2014) Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol 33(7):885–891CrossRefPubMed Ahmad J, Tagoe CE (2014) Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol 33(7):885–891CrossRefPubMed
4.
go back to reference Anwar S, Gibofsky A (2010) Musculoskeletal manifestations of thyroid disease. Rheum Dis Clin North Am 36(4):637–646CrossRefPubMed Anwar S, Gibofsky A (2010) Musculoskeletal manifestations of thyroid disease. Rheum Dis Clin North Am 36(4):637–646CrossRefPubMed
5.
go back to reference Bevilaqua-Grossi D, Chaves TC, de Oliveira AS, Monteiro-Pedro V (2006) Anamnestic index severity and signs and symptoms of TMD. Cranio 24(2):112–118CrossRefPubMed Bevilaqua-Grossi D, Chaves TC, de Oliveira AS, Monteiro-Pedro V (2006) Anamnestic index severity and signs and symptoms of TMD. Cranio 24(2):112–118CrossRefPubMed
6.
go back to reference Brito JP, Domecq JP, Prutsky G, Malaga G, Young L, Kargi AY (2013) Rhabdomyolysis and myopathy as the only manifestations of severe hypothyroidism secondary to Hashimoto’s thyroiditis. Rev Peru Med Exp Salud Publica 30(1):129–132CrossRefPubMed Brito JP, Domecq JP, Prutsky G, Malaga G, Young L, Kargi AY (2013) Rhabdomyolysis and myopathy as the only manifestations of severe hypothyroidism secondary to Hashimoto’s thyroiditis. Rev Peru Med Exp Salud Publica 30(1):129–132CrossRefPubMed
7.
go back to reference Cairns BE, Wang K, Hu JW, Sessle BJ, Arendt-Nielsen L, Svensson P (2003) The effect of glutamate-evoked masseter muscle pain on the human jaw-stretch reflex differs in men and women. J Orofac Pain 17(4):317–325PubMed Cairns BE, Wang K, Hu JW, Sessle BJ, Arendt-Nielsen L, Svensson P (2003) The effect of glutamate-evoked masseter muscle pain on the human jaw-stretch reflex differs in men and women. J Orofac Pain 17(4):317–325PubMed
8.
go back to reference Cakir M, Samanci N, Balci N, Balci MK (2003) Musculoskeletal manifestations in patients with thyroid disease. Clin Endocrinol (oxf) 59(2):162–167CrossRef Cakir M, Samanci N, Balci N, Balci MK (2003) Musculoskeletal manifestations in patients with thyroid disease. Clin Endocrinol (oxf) 59(2):162–167CrossRef
9.
go back to reference Campos JA, Carrascosa AC, Bonafe FS, Maroco J (2014) Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index. Braz Oral Res 28:16–21CrossRefPubMed Campos JA, Carrascosa AC, Bonafe FS, Maroco J (2014) Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index. Braz Oral Res 28:16–21CrossRefPubMed
10.
go back to reference Chrousos GP (1995) The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med 332(20):1351–1362CrossRefPubMed Chrousos GP (1995) The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med 332(20):1351–1362CrossRefPubMed
12.
go back to reference Craft RM, Mogil JS, Aloisi AM (2004) Sex differences in pain and analgesia: the role of gonadal hormones. Eur J Pain 8(5):397–411CrossRefPubMed Craft RM, Mogil JS, Aloisi AM (2004) Sex differences in pain and analgesia: the role of gonadal hormones. Eur J Pain 8(5):397–411CrossRefPubMed
13.
14.
go back to reference De Kanter RJ, Kayser AF, Battistuzzi PG, Truin GJ, Van ’t Hof MA (1992) Demand and need for treatment of craniomandibular dysfunction in the Dutch adult population. J Dent Res 71(9):1607–1612CrossRefPubMed De Kanter RJ, Kayser AF, Battistuzzi PG, Truin GJ, Van ’t Hof MA (1992) Demand and need for treatment of craniomandibular dysfunction in the Dutch adult population. J Dent Res 71(9):1607–1612CrossRefPubMed
15.
go back to reference De Kanter RJ, Truin GJ, Burgersdijk RC et al (1993) Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorder. J Dent Res 72(11):1509–1518CrossRefPubMed De Kanter RJ, Truin GJ, Burgersdijk RC et al (1993) Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorder. J Dent Res 72(11):1509–1518CrossRefPubMed
16.
go back to reference Devecerski G, Tomasevic S, Teofilovski M, Lazovic M, Konstantinovic L, Vulekovic P (2006) The frequency of metabolic and endocrine diseases in patients with various types of osteoarthritis. Med Pregl 59(Suppl 1):41–45PubMed Devecerski G, Tomasevic S, Teofilovski M, Lazovic M, Konstantinovic L, Vulekovic P (2006) The frequency of metabolic and endocrine diseases in patients with various types of osteoarthritis. Med Pregl 59(Suppl 1):41–45PubMed
17.
go back to reference Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6(4):301–355PubMed Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6(4):301–355PubMed
18.
go back to reference Dworkin SF, Massoth DL (1994) Temporomandibular disorders and chronic pain: disease or illness? J Prosthet Dent 72(1):29–38CrossRefPubMed Dworkin SF, Massoth DL (1994) Temporomandibular disorders and chronic pain: disease or illness? J Prosthet Dent 72(1):29–38CrossRefPubMed
19.
go back to reference Eayrs JT, Horn G (1955) The development of cerebral cortex in hypothyroid and starved rats. Anat Rec 121(1):53–61CrossRefPubMed Eayrs JT, Horn G (1955) The development of cerebral cortex in hypothyroid and starved rats. Anat Rec 121(1):53–61CrossRefPubMed
20.
go back to reference El-Midaoui A, Boujraf SA, Belahsen MF, Messouak O (2010) Thyroiditis of Hashimoto and myotonia. Neurosciences (Riyadh) 15(4):284–286 El-Midaoui A, Boujraf SA, Belahsen MF, Messouak O (2010) Thyroiditis of Hashimoto and myotonia. Neurosciences (Riyadh) 15(4):284–286
21.
go back to reference Eligar V, Taylor PN, Okosieme OE, Leese GP, Dayan CM (2016) Thyroxine replacement: a clinical endocrinologist’s viewpoint. Ann Clin Biochem 53(Pt 4):421–433CrossRefPubMed Eligar V, Taylor PN, Okosieme OE, Leese GP, Dayan CM (2016) Thyroxine replacement: a clinical endocrinologist’s viewpoint. Ann Clin Biochem 53(Pt 4):421–433CrossRefPubMed
22.
go back to reference Grenga V, Schiavoni R, Lubrano C (2004) Osteoarthritis of the temporomandibular joint in an adult patient with Hashimoto thyroiditis: case report. World J Orthod 5(3):254–259PubMed Grenga V, Schiavoni R, Lubrano C (2004) Osteoarthritis of the temporomandibular joint in an adult patient with Hashimoto thyroiditis: case report. World J Orthod 5(3):254–259PubMed
23.
go back to reference Hadithi M, de Boer H, Meijer JW et al (2007) Coeliac disease in Dutch patients with Hashimoto’s thyroiditis and vice versa. World J Gastroenterol 13(11):1715–1722CrossRefPubMedPubMedCentral Hadithi M, de Boer H, Meijer JW et al (2007) Coeliac disease in Dutch patients with Hashimoto’s thyroiditis and vice versa. World J Gastroenterol 13(11):1715–1722CrossRefPubMedPubMedCentral
24.
go back to reference Hashimoto H (1912) Zur Kenntnis der lymphomatösen Veränderung der Schilddrüse (Struma lymphomatosa). Arch Klin Chir 97:219–219 Hashimoto H (1912) Zur Kenntnis der lymphomatösen Veränderung der Schilddrüse (Struma lymphomatosa). Arch Klin Chir 97:219–219
25.
go back to reference Helkimo M (1974) Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Sven Tandlak Tidskr 67(2):101–121PubMed Helkimo M (1974) Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Sven Tandlak Tidskr 67(2):101–121PubMed
26.
28.
go back to reference Judex A, Hartung W, Scholmerich J, Fleck M (2008) Hypothyroidism with leading myopathy in a patient suffering from systemic lupus erythematosus and Hashimoto’s thyroiditis. Med Klin (Munich) 103(10):731–735CrossRef Judex A, Hartung W, Scholmerich J, Fleck M (2008) Hypothyroidism with leading myopathy in a patient suffering from systemic lupus erythematosus and Hashimoto’s thyroiditis. Med Klin (Munich) 103(10):731–735CrossRef
29.
go back to reference LeResche L (1997) Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med 8(3):291–305CrossRefPubMed LeResche L (1997) Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med 8(3):291–305CrossRefPubMed
30.
go back to reference LeResche L, Mancl L, Sherman JJ, Gandara B, Dworkin SF (2003) Changes in temporomandibular pain and other symptoms across the menstrual cycle. Pain 106(3):253–261CrossRefPubMed LeResche L, Mancl L, Sherman JJ, Gandara B, Dworkin SF (2003) Changes in temporomandibular pain and other symptoms across the menstrual cycle. Pain 106(3):253–261CrossRefPubMed
31.
32.
go back to reference Locker D, Slade G (1988) Prevalence of symptoms associated with temporomandibular disorders in a Canadian population. Community Dent Oral Epidemiol 16(5):310–313CrossRefPubMed Locker D, Slade G (1988) Prevalence of symptoms associated with temporomandibular disorders in a Canadian population. Community Dent Oral Epidemiol 16(5):310–313CrossRefPubMed
33.
go back to reference Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV (2002) Association between female hormonal factors and oro-facial pain: study in the community. Pain 97(1–2):5–10CrossRefPubMed Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV (2002) Association between female hormonal factors and oro-facial pain: study in the community. Pain 97(1–2):5–10CrossRefPubMed
34.
go back to reference Mastropasqua M, Spagna G, Baldini V, Tedesco I, Paggi A (2003) Hoffman’s syndrome: muscle stiffness, pseudohypertrophy and hypothyroidism. Horm Res 59(2):105–108PubMed Mastropasqua M, Spagna G, Baldini V, Tedesco I, Paggi A (2003) Hoffman’s syndrome: muscle stiffness, pseudohypertrophy and hypothyroidism. Horm Res 59(2):105–108PubMed
35.
go back to reference McLean RM, Podell DN (1995) Bone and joint manifestations of hypothyroidism. Semin Arthritis Rheum 24(4):282–290CrossRefPubMed McLean RM, Podell DN (1995) Bone and joint manifestations of hypothyroidism. Semin Arthritis Rheum 24(4):282–290CrossRefPubMed
36.
go back to reference McNeill C (1997) Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent 77(5):510–522CrossRefPubMed McNeill C (1997) Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent 77(5):510–522CrossRefPubMed
37.
go back to reference McNeill C, Mohl ND, Rugh JD, Tanaka TT (1990) Temporomandibular disorders: diagnosis, management, education, and research. J Am Dent Assoc 120(3):253–263CrossRefPubMed McNeill C, Mohl ND, Rugh JD, Tanaka TT (1990) Temporomandibular disorders: diagnosis, management, education, and research. J Am Dent Assoc 120(3):253–263CrossRefPubMed
38.
go back to reference Micheelis W, Reich E, Heinrich R, Zahnärzte IdD (1999) Dritte Deutsche Mundgesundheitsstudie (DMS III): Ergebnisse, Trends und Problemanalysen auf der Grundlage bevölkerungsrepräsentativer Stichproben in Deutschland 1997 vol 3. Deutscher Ärzte-Verlag, Köln Micheelis W, Reich E, Heinrich R, Zahnärzte IdD (1999) Dritte Deutsche Mundgesundheitsstudie (DMS III): Ergebnisse, Trends und Problemanalysen auf der Grundlage bevölkerungsrepräsentativer Stichproben in Deutschland 1997 vol 3. Deutscher Ärzte-Verlag, Köln
39.
go back to reference Minghelli B, Morgado M, Caro T (2014) Association of temporomandibular disorder symptoms with anxiety and depression in Portuguese college students. J Oral Sci 56(2):127–133CrossRefPubMed Minghelli B, Morgado M, Caro T (2014) Association of temporomandibular disorder symptoms with anxiety and depression in Portuguese college students. J Oral Sci 56(2):127–133CrossRefPubMed
40.
go back to reference Rodolico C, Toscano A, Benvenga S et al (1998) Myopathy as the persistently isolated symptomatology of primary autoimmune hypothyroidism. Thyroid 8(11):1033–1038CrossRefPubMed Rodolico C, Toscano A, Benvenga S et al (1998) Myopathy as the persistently isolated symptomatology of primary autoimmune hypothyroidism. Thyroid 8(11):1033–1038CrossRefPubMed
41.
go back to reference Roitt IM, Doniach D, Campbell PN, Hudson RV (1956) Auto-antibodies in Hashimoto’s disease (lymphadenoid goitre). Lancet 271(6947):820–821CrossRefPubMed Roitt IM, Doniach D, Campbell PN, Hudson RV (1956) Auto-antibodies in Hashimoto’s disease (lymphadenoid goitre). Lancet 271(6947):820–821CrossRefPubMed
42.
go back to reference Rosenthal MJ, Hunt WC, Garry PJ, Goodwin JS (1987) Thyroid failure in the elderly. Microsomal antibodies as discriminant for therapy. JAMA 258(2):209–213CrossRefPubMed Rosenthal MJ, Hunt WC, Garry PJ, Goodwin JS (1987) Thyroid failure in the elderly. Microsomal antibodies as discriminant for therapy. JAMA 258(2):209–213CrossRefPubMed
43.
go back to reference Salvatore D, Simonides WS, Dentice M, Zavacki AM, Larsen PR (2014) Thyroid hormones and skeletal muscle—new insights and potential implications. Nat Rev Endocrinol 10(4):206–214CrossRefPubMed Salvatore D, Simonides WS, Dentice M, Zavacki AM, Larsen PR (2014) Thyroid hormones and skeletal muscle—new insights and potential implications. Nat Rev Endocrinol 10(4):206–214CrossRefPubMed
44.
go back to reference Schiffman E, Ohrbach R, Truelove E et al (2014) Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache 28(1):6–27CrossRefPubMedPubMedCentral Schiffman E, Ohrbach R, Truelove E et al (2014) Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache 28(1):6–27CrossRefPubMedPubMedCentral
45.
go back to reference Schiffner U, Hoffmann T, Kerschbaum T, Micheelis W (2009) Oral health in German children, adolescents, adults and senior citizens in 2005. Community Dent Health 26(1):18–22PubMed Schiffner U, Hoffmann T, Kerschbaum T, Micheelis W (2009) Oral health in German children, adolescents, adults and senior citizens in 2005. Community Dent Health 26(1):18–22PubMed
46.
go back to reference Soy M, Guldiken S, Arikan E, Altun BU, Tugrul A (2007) Frequency of rheumatic diseases in patients with autoimmune thyroid disease. Rheumatol Int 27(6):575–577CrossRefPubMed Soy M, Guldiken S, Arikan E, Altun BU, Tugrul A (2007) Frequency of rheumatic diseases in patients with autoimmune thyroid disease. Rheumatol Int 27(6):575–577CrossRefPubMed
47.
48.
go back to reference Tagoe CE, Zezon A, Khattri S (2012) Rheumatic manifestations of autoimmune thyroid disease: the other autoimmune disease. J Rheumatol 39(6):1125–1129CrossRefPubMed Tagoe CE, Zezon A, Khattri S (2012) Rheumatic manifestations of autoimmune thyroid disease: the other autoimmune disease. J Rheumatol 39(6):1125–1129CrossRefPubMed
52.
go back to reference Von Korff M, Dworkin SF, Le Resche L (1990) Graded chronic pain status: an epidemiologic evaluation. Pain 40(3):279–291CrossRef Von Korff M, Dworkin SF, Le Resche L (1990) Graded chronic pain status: an epidemiologic evaluation. Pain 40(3):279–291CrossRef
53.
go back to reference Von Korff M, Dworkin SF, Le Resche L, Kruger A (1988) An epidemiologic comparison of pain complaints. Pain 32(2):173–183CrossRef Von Korff M, Dworkin SF, Le Resche L, Kruger A (1988) An epidemiologic comparison of pain complaints. Pain 32(2):173–183CrossRef
54.
go back to reference Waltuck J (2000) Musculoskeletal manifestations of thyroid disease. Bull Rheum Dis 49(11):1–3PubMed Waltuck J (2000) Musculoskeletal manifestations of thyroid disease. Bull Rheum Dis 49(11):1–3PubMed
55.
go back to reference Wanman A, Agerberg G (1986) Mandibular dysfunction in adolescents. II. Prevalence of signs. Acta Odontol Scand 44(1):55–62CrossRefPubMed Wanman A, Agerberg G (1986) Mandibular dysfunction in adolescents. II. Prevalence of signs. Acta Odontol Scand 44(1):55–62CrossRefPubMed
56.
go back to reference Wanman A, Agerberg G (1986) Relationship between signs and symptoms of mandibular dysfunction in adolescents. Community Dent Oral Epidemiol 14(4):225–230CrossRefPubMed Wanman A, Agerberg G (1986) Relationship between signs and symptoms of mandibular dysfunction in adolescents. Community Dent Oral Epidemiol 14(4):225–230CrossRefPubMed
57.
go back to reference Weetman AP (2003) Autoimmune thyroid disease: propagation and progression. Eur J Endocrinol 148(1):1–9CrossRefPubMed Weetman AP (2003) Autoimmune thyroid disease: propagation and progression. Eur J Endocrinol 148(1):1–9CrossRefPubMed
58.
go back to reference Weetman AP (2013) The immunopathogenesis of chronic autoimmune thyroiditis one century after hashimoto. Eur Thyroid J 1(4):243–250PubMed Weetman AP (2013) The immunopathogenesis of chronic autoimmune thyroiditis one century after hashimoto. Eur Thyroid J 1(4):243–250PubMed
59.
go back to reference Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–236CrossRefPubMed Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–236CrossRefPubMed
Metadata
Title
Prevalence of temporomandibular disorders in patients with Hashimoto thyroiditis
Authors
Alina Grozdinska
Elisabeth Hofmann
Matthias Schmid
Ursula Hirschfelder
Publication date
01-07-2018
Publisher
Springer Medizin
Published in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Issue 4/2018
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-018-0140-6

Other articles of this Issue 4/2018

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 4/2018 Go to the issue

Mitteilungen DGKFO

Mitteilungen DGKFO