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Stress and Orality

Abstract

Experts have recently studied the possible correlation between TMD and other pathologies with symptoms similar to those of some clinical forms of migraine, fibromyalgia, and chronic fatigue. All oral structures play a role in the adaptation of human life mechanisms and respond to daily stressors such as eating or communicating. In all cases, muscles are buffer elements that try to maintain analgesic and proper functional conditions; their failure to do so generates referred pain and/or discomforts. The reader must bear to keep in mind two important facts: (1) trigeminal information can reach various non-trigeminal central, cranial, and spinal nervous areas and (2) the nature of the paired V is admittedly highly reflexogenic. Abnormal excessive and/or nociceptive inputs could oversensitize the trigeminal nervous centers and be involved in generating some unexpected symptoms without any evident link with the oral sphere. This is particularly true in stressed and introverted patients with oral parafunctional habits such as severe teeth clenching. Do the trigeminal sensory-motor territories serve as a sounding board to stress if we consider the importance of the oral sphere in human beings? Clinicians should no longer be puzzled by unexplained irregular heart rate, digestive problems, dizziness, lumbar pain, or painful calf spasms in stressed and introverted patients who clench their teeth tightly and/or durably and/or frequently. There can also be cases of atypical clinical forms classified as fibromyalgia, migraine, and chronic fatigue.

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Notes

  1. 1.

    The link between TMJ disorders and occlusal or vertical dimension defects as factors contributing to pain and disorders of the stomatognathic system has been discussed for many years. A number of EMG studies seem to confirm this role, while others fail to show any such correlation. The ­bio-mechanistic approach gave preferential importance to “TMJ internal derangement” and influenced the design of articulators [26, 35, 75]. Some etiological factors related with dental occlusion were considered to be relevant: loss of posterior tooth and supporting zone [42, 43, 155, 156], maxillomandibular disproportion [113], abnormality of VDO [42, 60, 71], interposition of tongue between dental arches [60], infantile swallowing, and general abrasion of teeth caused by grinding. Another recurring theme is the consideration of postural and traumatic factors, not only at the level of the stomatognathic system but also as part of the global postural body system [37, 47, 96, 124].

  2. 2.

    Many studies gave recognition to prevalence of central and psychosocial stressful factors in orofacial disorders [4, 15, 16, 21, 28, 31, 36, 42, 45, 51, 57, 62, 64, 67, 76, 79, 82, 83, 91, 98, 99, 102, 114, 115, 123, 125, 127, 129, 131, 133, 134, 141, 146, 152154] in which frustration [53], even more than anxiety, seemed to be predisposing factors [138].

  3. 3.

    About local RMT, it can be evoked the situation of the otic gg. into infratemporal fossa, according to sedative effects on some migraines. The sympathetic root of otic gg., after entering into the skull, divides itself in a perivascular plexus to the arteria meningea medialis which is involved in migrainous phenomena. Figure 3 schematically presents anastomosis between V3 and otic gg. which of an efferent branch is distributed to the nervous plexus of arteria meningea medialis (branch of the arteria maxillaris).

  4. 4.

    References: Paprotka et al. [103] and Knox [68].

  5. 5.

    Continuing psycho-emotional tension is known to generate local muscular tension and widespread insidious contractures. Many years ago, Martenot tried to focus the clinicians’ attention on these pathophysiological conditions as a big source of metabolic disturbances: tissular acidosis, hypoxia, non-eliminated free radicals, etc. may be suspected to facilitate abnormal states of chronic fatigue. Relaxation methods seem greatly useful to prevent or improve this kind of psychosomatic tendency [84].

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Hartmann, F., Cucchi, G. (2014). Medical Prospects. In: Stress and Orality. Springer, Paris. https://doi.org/10.1007/978-2-8178-0271-8_16

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