Dietary Fiber Intake in Patients with Myofascial Face Pain

Aims: To determine the impact of myofascial face pain (MFP) on dietary intake of selected nutrients. Methods: Sixty-one MFP women meeting the criteria for the myofascial subtype of temporomandibular disorders completed a 4-day daily food intake diary, as well as self-report of pain severity, pain interference with eating, and depressive symptomatology. Nutrient intake for the MFP women was compared with a demographically-equivalent sample of community women participating in the federally-sponsored Continuing Survey of Food Intakes by Individuals (CFSII). Within the MFP sample, multiple linear regression analysis was used to test whether dietary fiber intake reduction was most likely due to pain adaptation, or to depressive symptomatology or associated appetite reduction. Results: Only the subgroup of MFP patients with above-average pain severity showed reduced dietary fiber intake compared with the community sample. MFP patients did not differ from the community sample on other nutrient intake measures (ie, total calories, protein, fat, carbohydrates and dietary fiber, calcium, and iron). Within the MFP sample, pain severity was significantly associated with reduced dietary fiber intake. This relationship persisted, after controlling for depressive symptomatology, appetite, and total calories. Conclusion: Myofascial face pain patients with more severe pain intensity are likely to reduce their intake of dietary fiber. This is likely due to an effort to decrease masticatory activity to avoid exacerbating facial pain. Since low dietary fiber, especially in combination with commonly prescribed medications for MFP, increases the risk of constipation and may exacerbate comorbid medical conditions, clinicians should recommend alternative dietary fiber sources for MFP patients. Keywords: myofascial face pain, temporomandibular disorders, quality of life, pain, nutrition