Are oral overuse behaviours associated with painful temporomandibular disorders? A cross‐sectional study in Portuguese university students

Abstract

Background Many different types of oral overuse behaviours occur frequently in adult populations with painful temporomandibular disorders (TMDs). Less is known regarding these behaviours and their associations with TMDs in university students. Objectives Test the association between frequency of different oral overuse behaviours evaluated by the Oral Behaviour Checklist (OBC) and the severity of painful TMDs. Methods In this cross‐sectional study, 1381 students from 19 universities in the Oporto District, Portugal, completed the Research Diagnostic Criteria for TMD (RDC/TMD) Personal History Questionnaire and the OBC, and they received an RDC/TMD clinical examination. The OBC sum score (ranging from 0 to 84 points) was classified as normal (0 ≤ 16 points), low overuse (17 ≤ 24) or high overuse (≥25). Painful TMD subtypes (myalgia, arthralgia or combined) were identified. Associations were tested using multivariable binary logistic regression models (α = .05), adjusted for age and sex, and referencing the normal parafunction group. Results University students with high overuse were more likely to have a painful TMD: myalgia (OR = 1.9, 95% CL: 1.3–3.0); arthralgia (OR = 2.2; 95% CL: 1.4–3.4), combined (OR = 5.0; 95% CL: 3.1–8.1). Students with low overuse were more likely to have only the combined painful TMD (OR = 2.4; 95% CL: 1.4–4.0) but not the individual painful disorders. Of the 21 different behaviours, 13 were reported at least 50% of the time. Conclusions In this university student sample, oral overuse behaviours are widespread, and their overall extent exhibited a dose‐response relationship with respect to severity of painful TMDs based on pain and chronicity. Only some behaviours were independently associated with painful TMDs, suggesting the value of further OBC instrument development.

Diagnostic criteria for temporomandibular disorders—INfORM recommendations: Comprehensive and short‐form adaptations for children

“…Although there is still some uncertainty concerning the role of oral overuse behaviours in TMDs, there is a strong association between oral overuse behaviours and the onset of painful TMD in adults 47,71–73 . Concerning sleep bruxism in children, studies have found an association of TMD pain with sleep bruxism 74 and with daytime parafunction (for example grinding, clenching or pressing teeth, holding objects between teeth and use of chewing gum) 75,76 .…”

“…48 The full 20-item instrument captures jaw-related limitations using Although there is still some uncertainty concerning the role of oral overuse behaviours in TMDs, there is a strong association between oral overuse behaviours and the onset of painful TMD in adults. 47,[71][72][73] Concerning sleep bruxism in children, studies have found an association of TMD pain with sleep bruxism 74 and with daytime parafunction (for example grinding, clenching or pressing teeth, holding objects between teeth and use of chewing gum). 75,76 To evaluate oral overuse behaviours in children, the OBC-21 adult version was chosen for the comprehensive version, and the 6-item version is included in the short version.…”

The effect of singing on pain and psychological well‐being in a patient population with pain‐related temporomandibular disorders

“…As a result, since different clusters of OBC questions seem to represent different mechanisms of loading of the masticatory system and thus require different motor recruitment patterns, it can be expected that only a selection of these behaviours has the capacity to contribute to TMD‐pain onset and chronicity. A recent study, performed amongst 1381 university students, corroborates this hypothesis 46 . The authors found that oral overuse behaviours are widespread, and their overall extent exhibited a dose–response relationship with respect to severity of painful TMDs based on pain and chronicity.…”

“…45 The non-functional be- this hypothesis. 46 The authors found that oral overuse behaviours are widespread, and their overall extent exhibited a dose-response relationship with respect to severity of painful TMDs based on pain and chronicity. However, only few behaviours were independently associated with painful TMDs.…”

Personality, psychosocial and oral behavioural risk factors for temporomandibular disorder symptoms in Asian young adults

“…Global oral behaviours (total OBC scores) vary between 0 and 84 points and are categorised as normal (0 to 16 points), low (17 to 24 points) and high (25 to 84 points) 'jaw use behaviours'. 22,41 The two sleep-related oral activities scrutinised are teeth clenching/grinding when asleep and sleeping in positions that put pressure on the jaws. Waking-state oral behaviours are grouped into six nonfunctional and six functional oral activities.…”