Objective: The aim of this study was to investigate patients with classical (cEDS) and hypermobile (hEDS) Ehlers-Danlos syndrome (EDS) with regard to the prevalence and quality of temporomandibular disorders (TMD). In addition, the connection to chronic pain and psychological distress was investigated. EDS are classified as rare diseases, of which 13 subtypes can be distinguished according to the current classification (1). hEDS and cEDS are among the two most common subtypes (1,2). A characteristic feature is hypermobility of the joints. According to current literature, patients with EDS suffer more frequently from temporomandibular joint problems (3). The study conducted here is intended to be a further step in the research of the disease and the development of individualised treatment methods.
Methods: Participants were recruited via self-help groups in Germany, Austria and Switzerland as well as via social media and subjected to an online questionnaire. Free-text questions on TMD-specific symptoms and previously diagnosed TMDs and their treatment, the German version of the Depression Anxiety and Stress Scale and the German version of the Graded Chronic Pain Status were used.
Results: 259 participants were included (230 hEDS/29 cEDS). 49.2% of participants had painful or restricted jaw movements, and 84.9% had pain in the masticatory muscles, with 46.3% having a previously diagnosed TMD. A significance analysis showed a 2.5-fold higher risk of chronic pain in participants with diagnosed TMD. 22% of participants had a critical score for depression, 53.3% had a critical score for anxiety and 34.0% had a critical score for stress.
Conclusion: CMD problems and chronic pain are common in patients with cEDS and hEDS. The lack of knowledge about these problems can lead to psychological distress. Further research is needed to adequately treat patients with EDS and to develop individualised treatment concepts.
Keywords: Ehlers-Danlos syndrome, oral health, rare diseases, temporomandibular disorder
