Influence of Gender on pain: In Temporomandibular Disorders
Most patients with TMD disorders will respond to non-operative therapy involving; control of parafunctional behaviors, exercises to restore good jaw function, and use of analgesics and muscle relaxers during episodes of acute pain and dysfunction. But up to 20% of TMD patients will not respond to these conventional treatments and multiple factors influenced by gender can be responsible for this poor response.Prolonged nociception in such patients can lead to the peripheral and central nervous system sensitization, as evidenced by low pain thresholds and temporal summation, routinely encountered in patients with chronic TMD symptoms, but also female patients in general. Tailoring treatment to address these gender –based contributing factors is the challenge that providers must meet for successful management of chronic TMD patients. This chapter evaluates gender as an initiating, predisposing, or perpetuating factor for TMD via the role of sex hormones, muscle activity and parafunctional behaviors, pain perception, and genetics.
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