Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Patients Examination
2.3. Extraoral Examination
- (a)
- The pain was localized around the temporomandibular joint (TMJ), temporalis, or masseter muscles.
- (b)
- The patient reported pain in the TMJ, aggravated by palpation of the lateral pole or around it when the mouth was closed.
- (c)
2.4. Intraoral Examination
- Probing depth (PD), measured using a 15-UNC probe and recorded to the nearest 1 mm (PCP- UNC 15; Hu- Friedy, Chicago, IL, USA) at 6 points around all teeth.
- Plaque index (PI) assessed the amount of visible dental plaque [22].
- The DMFt (decayed-D, missing-M, and filled-F teeth) score (ranging from 0–28) assesses the prevalence and treatment needs of dental caries [23]. The score is the sum of carious, absent, and obturated teeth. The third molars were not considered in the count.
- Intraoral hard and soft tissue pathologies.
- Occlusal tooth wear is classified into three categories: 0: no wear; 1: wear confined to the enamel; and 2: severe—wear with exposed dentin [24].
- Number of dental implants.
2.5. Periodontal Diagnosis
2.6. Statistical Analysis
3. Results
4. Discussion
Limitations and Strengths
5. Conclusions
- PTSD patients have high dental and oral pathologies, especially those treated with psychiatric medications.
- Our findings suggest that all patients with PTSD should undergo complete periodontal, oral, and dental examinations periodically and comprehensive education and training regarding proper oral hygiene.
- The use of night guards is frequently indicated in Ci-PTSD.
- The recognition of the particular needs of these patients concerning oral, periodontal, facial, and TMJ health can prevent dental complications and improve quality of life.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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PTSD | PTSD | Control | Significance | ||||
---|---|---|---|---|---|---|---|
Total (n = 100) | With Medication (n = 40) | Without Medication (n = 60) | (n = 103) | Overall (ANOVA 3 Groups) | Post-Hoc (Tukey B Test) | ||
Sex | Male | 97 (97%) | 39 (97.5%) | 58 (97%) | 102 (99%) | ||
Female | 3 (3%) | 1 (2.5%) | 2 (3%) | 1 (1%) | |||
Age | 60.55 ± 11.70 | 63.30 ± 10.79 | 56.43 ± 11.92 | 59.93 ± 13.29 | p = 0.024 | Med non- med p < 0.05 | |
PI | 0.72 ± 0.28 | 0.80 ± 0.24 | 0.67 ± 0.29 | 0.45 ± 0.29 | p < 0.001 (*) | Any two groups of the 3 are different with p < 0.05 | |
Decayed Missing Filled | 3.47 ± 3.46 | 4.13 ± 4.63 | 3.03 ± 2.33 | 0.58 ± 1.24 | p < 0.001 | - “ - | |
5.78 ± 6.95 | 5.60 ± 7.80 | 5.90 ± 6.38 | 3.98 ± 4.89 | p = 0.102 | N/S | ||
10.70 ± 5.63 | 9.65 ± 6.60 | 11.4 ± 4.85 | 8.50± 4.76 | p = 0.003 | Control–non- med p < 0.05 | ||
DMF | 19.97 ± 8.07 | 19.48 ± 9.28 | 20.30 ± 7.22 | 13.05 ± 6.23 | p < 0.001 | Control–PTSD p < 0.05 | |
Implants | 1.15 ± 2.12 | 1.08 ± 2.011 | 1.25 ± 2.30 | 2.0 ± 3.21 | p = 0.085 | N/S |
PTSD | Control | Test #Conditions × #Groups Significance | |||
---|---|---|---|---|---|
With Medication | Without Medication | ||||
Smoking status | Never | 16 (40.0%) | 43 (71.7%) | 71 (68.9%) | Pearson Chi-Square 4 × 3 p < 0.001 |
Heavy | 22(55.0%) | 13 (21.7%) | 16 (15.5%) | ||
Light | 0 (0.0%) | 1 (1.7%) | 10 (9.7%) | ||
Former | 2 (5.0%) | 3 (5%) | 6 (5.8%) | ||
Periodontal disease status: Severity | Mild- Moderate (Stages I or II) | 15 (37.5%) | 42 (70.0%) | 75 (72.8%) | Pearson Chi-Square 2 × 3 p < 0.001 |
Severe (Stages III or IV) | 25 (62.5%) | 18 (30.0%) | 28 (27.2%) | ||
Grading | B | 12 (30.0%) | 25 (41.7%) | 35 (34.0%) | Non-Significant |
C | 22 (55%) | 21 (35.0%) | 28 (27.2%) | Non-Significant | |
Local– General | Localized | 12 (30%) | 26 (43.3%) | 53 (51.5%) | Pearson Chi-Square 2 × 3 p = 0.066 |
Generalized | 28 (70%) | 34 (56.7%) | 50 (48.5) | ||
Tooth wear (edentulous patients not included) | None | 2 (5.6%) | 3 (5.1%) | 27 (26.5%) | Pearson Chi-Square 3 × 3 p < 0.001 |
Mild | 8 (22.2%) | 13 (22%) | 42 (41.2%) | ||
Severe | 26 (72.2%) | 43 (72.9%) | 33 (32.4%) | ||
Night guard (no edentulous patients) | No | 12 (33.3%) | 34 (57.6%) | 94 (92.2%) | Pearson Chi-Square 2 × 3 p < 0.001 |
Yes | 24 (66.7%) | 25 (42.4%) | 8 (7.8%) | ||
TMJ/Facial pain | No | 12 (30.0%) | 31 (51.7%) | 90 (88.2%) | Pearson Chi-Square 2 × 3 p < 0.001 |
Yes | 28 (70.0%) | 29 (48.3%) | 12 (11.8%) |
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Tagger-Green, N.; Nemcovsky, C.; Fridenberg, N.; Green, O.; Chaushu, L.; Kolerman, R. Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study. J. Clin. Med. 2022, 11, 3249. https://doi.org/10.3390/jcm11113249
Tagger-Green N, Nemcovsky C, Fridenberg N, Green O, Chaushu L, Kolerman R. Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study. Journal of Clinical Medicine. 2022; 11(11):3249. https://doi.org/10.3390/jcm11113249
Chicago/Turabian StyleTagger-Green, Nirit, Carlos Nemcovsky, Naama Fridenberg, Orr Green, Liat Chaushu, and Roni Kolerman. 2022. "Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study" Journal of Clinical Medicine 11, no. 11: 3249. https://doi.org/10.3390/jcm11113249
APA StyleTagger-Green, N., Nemcovsky, C., Fridenberg, N., Green, O., Chaushu, L., & Kolerman, R. (2022). Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)—A Cross-Sectional Study. Journal of Clinical Medicine, 11(11), 3249. https://doi.org/10.3390/jcm11113249