"Grin(d) and Bear it": Narratives from Sami Women With and Without Temporomandibular Disorders. A Qualitative Study

Aims: To explore thoughts, experiences, and beliefs regarding temporomandibular disorders (TMD) among Sami women with and without TMD in order to gain insights into their health care experiences and to generate a hypothesis regarding factors associated with long-standing TMD. Methods: Qualitative thematic interviews were conducted with a strategic sample of 17 Sami women, of whom 10 had a TMD diagnosis according to the Research Diagnostic Criteria for TMD and 7 age-matched women who had no signs or symptoms of TMD. Their ages were between 23 and 58 years. The thematic interviews were audiotaped, transcribed verbatim, and analyzed based on Grounded Theory, a qualitative methodology aiming to generate hypotheses grounded in the gathered data. Results: The core category that evolved was "Grin(d) and bear it," which summarizes the Sami participants' various ways and stages of processing and handling the interacting categories (triggers, strains, distrust, and reconciliation with pain and/or difficulties in life). They described divergent as well as similar understandings of triggering factors. Maintaining factors were described as mental-physical strain and stress, and also a jaw-clenching behavior. Women without TMD contributed with factors that helped them to handle strains, reconcile, and stay healthy. They relied on strong social support. Conclusion: Based on the analysis, the following hypothesis was generated: Women with TMD, associated headaches, and neck-shoulder pain may benefit from efforts aimed at empowering them to use their own abilities to reduce stress behavior, strain, and disuse of the jaw. Rehabilitation strategies in groups might increase their sense of coherence and increase social support, which seems to be more limited than in women with no symptoms of TMD. Keywords: chronic pain, consultation, qualitative research, Sami, temporomandibular, women's health