Is use of exogenous estrogen associated with temporomandibular signs and symptoms?

Background. Studies of historical data suggest a link between exogenous est rogen use and referral for treatment for temporomandibular disorders, or TM Ds. The purpose of the authors' study was to determine the association betw een exogenous estrogen use and signs and symptoms of TMD assessed by direct physical examination in a randomly selected community sample of primarily postmenopausal women. Methods. A calibrated clinical examiner examined a stratified random sample of 510 women aged 37 to 82 years using the Craniomandibular Index, or CMI. All medications that subjects were taking at the time of the examination w ere identified by interview and examination of subjects' medication contain ers on two occasions. One hundred seventy-four subjects were taking medicat ions containing estrogen, and 336 were taking no such medications. Results. The muscle and joint signs and symptoms of women taking and not ta king estrogen were not significantly different after the authors controlled for sociocultural, demographic and health care utilization variables. Estr ogen use also failed to distinguish women receiving relatively high and low scores on the CMI. Conclusions. Estrogen replacement therapy does not place women at increased risk of developing TMDS. Clinical Implications. Clinicians need not be concerned that patients takin g oral contraceptives or replacement estrogens are at increased risk of dev eloping TMDs.