Aims
To compare the difference in the quality of life between temporomandibular disorders (TMD) patients and non-TMD subjects diagnosed with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).
Methods
Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE) and Latin American and Caribbean Health Sciences Literature (LILACS) databases were searched in studies published in English and Portuguese. The search was performed by two independent reviewers in duplicate. A manual search and the gray literature were also included. The inclusion criteria were clinical studies that used the RDC/TMD axis I and quality of life with standard questionnaires in young and middle-aged adult population (18–55 years). The data were analyzed quantitatively by combining the results in a meta-analysis using forest plots. The measure of effect used was the standardized mean difference (SMD) in depression levels. The Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of the studies. The publication bias was assessed by funnel plots. The initial search included 806 articles without duplications.
Results
Twenty-four articles were included in the final systematic review. Of these, 9 were included in the meta-analysis, where it was shown a statistically significant in all axis I groups: (a) global TMD—groups I, II and III combined, N = 3829, SMD (95% CI) = 1.06 (0.65–1.51), p = 0.000; (b) group I—muscle disorders, N = 3,056, SMD (95% CI) = 0.82 (0.45–1.18), p = 0.000; (c) group II—disc displacements, N = 3,184, SMD (95% CI) = 0.59 (0.26–0.91), p = 0.000; and (d) group III—arthralgia/arthritis/arthrosis, N = 2781, SMD (95% CI) = 0.98 (0.59–1.36), p = 0.000. When compared to controls.
Conclusions
Quality of life is affected in all axis I TMD patients, especially in groups I and III with higher pain intensity and disability as compared to group II.
According to the American Academy of Orofacial Pain (AAOP), temporomandibular disorders (TMD) are a set of pathological conditions characterised by pain or limitation of movement in the temporomandibular joint(s) (TMJ), the masticatory muscles or both. 1,2 The main functional, physical and psychosocial consequences of TMD may significantly impair oral health and quality of life. 2,3 It is a multifactorial condition triggered by initiating co-factors: existing pain conditions, trauma, parafunction or emotional distress, which affect the stomatognathic system's homeostasis. 4 The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was published in 1992 and has been the standard diagnostic tool for TMD until 2014, when the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was published. 5,6 The TMD chronic pain is frequently related to other chronic pain conditions (ie tension headaches, fibromyalgia, chronic fatigue and irritable bowel syndrome) and present neuroendocrine abnormalities, biopsychosocial distress, fatigue, impaired sleep quality, anxiety and/or depression. 7 Sleep quality and TMD relationship have been studied since 1995. 6 It was found that mandibular pain was twice as high in
Background
To study the association between sleep quality and oral health related variables, which still have conflicts in the literature.
Material and Methods
This was a population-based case-control study between subjects with versus without sleep disorders from the Brazilian Public Health System (SUS), city of Maringá (N=1,643). Subjects answered self-reported questionnaires: a) Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), b) Sleep Assessment Questionnaire (SAQ) and c) North York Dental Health Survey (NYDHS).
Results
No significant difference was found for gender, marital status, or income; however, non-Caucasians, people with lower levels of education, and those between 20 to 50 years old had worse scores of sleep disorders in the SAQ. Self-perceived oral health, masticatory capacity to eat foods, and gingival bleeding was significantly worse among subjects with self-reported sleep disorders. Self-reported tooth loss, edentulism and use of removable partial dentures (with clasps) or complete dentures showed no significant difference between groups. Self-reported sleep disorder subjects presented significantly higher prevalence of both self-reported tooth and TMJ pain.
Conclusions
It can be concluded that individuals with self-reported sleep disorders presented worse self-perceived oral health for most studied variables.
Key words:
Oral health, case control study, sleep; review, gingivitis, periodontitis, tooth loss.
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