Intervenções dietéticas e manejo da dor crônica: evidências científicas e aplicabilidade na área de DTM e dor orofacial

Abstract

Healthy dietary interventions have been shown to reduce biomarkers of peripheral and central inflammation, however, there is a lack of evidence on the influence of diet on temporomandibular disorder (TMD). The goal of this study was to conduct a literature review on the impact of dietary interventions on pain symptomatology in individuals with chronic disorders, and to inform future studies on the field of nutrition with application to TMD and Orofacial Pain. A PubMed database research was performed with the terms "pain," "diet," and "dietary intervention. Articles published in the last 10 years in English, that performed clinical dietary interventions in individuals with chronic pain disorders were included. Those incompatible with the topic and literature reviews were excluded. 424 titles were identified, of which 10 filled in the eligibility criteria. These included studies performed dietary interventions - vegan-type, omega-3-rich, DASH-type with different sodium levels, amino acid supplemented, ovo-lacto-vegetarian, gluten-free, low in carbohydrates and fats, and supplemented with polyphenols - in individuals with headache and chronic musculoskeletal disorders. For migraine and other headache disorders, the vegan, omega-3-rich, and sodium-reduced interventions were shown to be effective on improving pain, biochemical changes consistent with reduced nociception, and in reduced chance of headache disorders, respectively. Essential amino acid supplementation was substantially important for individuals with chronic low back pain; the ovo-lacto-vegetarian diet proved advantageous for pain, function, and quality of life in individuals with chronic musculoskeletal pain; and for pain in the masticatory muscles, women with TMD showed reduced pain sensitivity after intervention with a gluten-free diet. The low-calorie and gluten-free diets also demonstrated efficacy for general fibromyalgia symptoms. Low-carbohydrate intervention was more satisfactory than lowfat diet for general osteoarthritis symptoms and oxidative stress reduction; polyphenol supplementation was satisfactory for osteoarthritis and chronic disorders in general. Thus, a more near-natural diet rich in fruits, vegetables, whole grains, eggs, and omega-3, combined with a reduction of processed foods and meals with excess sodium and gluten, seems to be favorable and beneficial for individuals with chronic pain disorders, requiring studies about its application in the area of TMD and Orofacial Pain.