Association between psychological factors and temporomandibular disorders in adolescents of rural and urban zones

Abstract

Background Temporomandibular disorders (TMD) are related to psychological factors. Adolescence is one of the stages in life with more psychosocial vulnerability, which is dissimilar in rural and urban zones. Thus, the aim of this investigation was to evaluate the association between psychological factors (symptoms of anxiety, depression and somatization) and TMD in adolescents between 12 and 15 years, belonging to urban and rural zones of Colombia. Methods 180 subjects aged 12–15 years (mean 13.8, SD 1.2), enrolled in public schools in the rural (n = 90) and urban (n = 90) zones were included. All subjects were evaluated using the DC/TMD instrument; the Axis I was applied for the clinical examination and the Axis II for the psychological evaluation. Data were analyzed by means of T-student, Mann–Whitney, Kruskall–Wallis tests, Pearson Chi square and multiple-variable analysis with logistic regression. Results Forty percent of the included subjects presented some type of TMD. TMD related to pain were the most common (25.5% of the studied adolescents), being myalgia the most common (20% of the adolescents in urban zone and 31.1% of the adolescents in the rural zone). There was no difference between the TMD present in males and females, but there were differences in the symptoms of Anxiety, and Somatization (p < 0.05). TMD and psychological factors were more prevalent in children with 13 years of age. A statistically significant association between TMD and symptoms of Anxiety (Pearson Chi squared 25.57, p = 0.04), depression (Pearson Chi squared 33.28, p = 0.03) and somatization (Pearson Chi squared 25.79, p = 0.04) was found in subjects from rural zones. No associations between psychological aspects and TMD were found in subjects from urban zones, but overall all psychological factors significantly influenced TMD. Conclusion This study indicates Myalgia to be the most prevalent TMD in studied Colombian adolescents. Pain-related TMDs are associated with psychological factors in the adolescent population of rural Colombia. Symptoms of anxiety, depression and somatization were found to be associated to TMD, even when the frequency was not necessarily severe.

Predictability and Accuracy of the Short-Form Fonseca Anamnestic Index in Relation to the Modified Helkimo Index for the Diagnosis of Temporomandibular Disorders

“…Further, due to the study design, it was not possible to extrapolate the results of TMD prevalence to the entire Peruvian population, so more epidemiological studies are needed in Peru, with a large scope, that apply the SFAI for the identification of TMD. However, apart from the constant monitoring of the temporomandibular joint in patients with related symptomatology due to anxiety or stress disorders,[ 5 12 , 34 ] bruxism, and partial edentulism, among others,[ 10 32 ] being necessary, it would be very useful to use the SFAI as a rapid diagnostic test to detect TMD in large populations where it is required to evaluate the largest number of people in a relatively short time and at low cost. It is recommended that more studies of predictability and precision of the SFAI be carried out in different regions of Peru and Latin America, in order to evaluate possible exogenous variables that affect its predictive efficacy.…”

“…To diagnose the different TMDs, different indexes have been created, with the Helkimo Index being one of the most used and widely accepted, since it has withstood the test of time for being simple and practical, allowing it to quantify the existing dysfunction and also allowing it to correlate the patient’s symptoms and the clinical finding, in comparison to other clinical indexes. [ 10 11 ] However, the Helkimo Index was later modified by Maglione[ 12 13 ] in 1982 in order to improve the determination of severity. On the other hand, it should be recognized that this high instrument accuracy requires the application of clinical procedures that require a considerable amount of time, a situation that is not useful for studies in large populations.…”

Alterações psicológicas durante a pandemia por COVID-19 e sua relação com bruxismo e DTM

“…Dos artigos incluídos nesta revisão, 7 abordavam aspectos psicossociais e sua relação com a pandemia por COVID-19 (Di Blasi et al, 2021;De Boni et al, 2020;Gutiérrez-Hernández et al, 2021;Limcaoco et al, 2020;Liao et al, 2021;Liu et al, 2021;Wang et al, 2021), 5 apresentavam os aspectos psicossociais e sua relação com DTM (Alahmary, 2019;Guimarães;Almeida, 2018;Canales et al, 2019;Yap;Natu, 2020;Zavanelli, 2017) e 7 dissertavam sobre a associação entre as alterações psicológicas causadas pela pandemia por COVID-19 e sua relação com bruxismo e DTM (Asquini et al, 2021;Emodi-Perlman et al, 2020;Gaş;Özsoy;Aydin, 2021;Medeiros et al, 2020;Restrepo et al, 2021;Saccomanno et al, 2020;Silva et al 2021).…”

“…Houve correlação positiva entre comportamentos orais e sintomas de DTM, ansiedade e depressão. Restrepo et al, 2021 Estudo transversal. Avaliar a associação entre fatores psicológicos (sintomas de ansiedade, depressão e somatização) e DTM em adolescentes entre 12 e 15 anos, pertencentes às zonas urbana e rural da Colômbia.…”

Effects of Warm Needle Acupuncture on Temporomandibular Joint Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Mouth-opening limitation, oral and maxillofacial pain, and joint clanging are the most common symptoms, which severely affects the quality of life of patients with TMD [ 1 , 2 ]. Anxiety, depression, somatization, and other psychological factors are closely related to the generation of TMD [ 3 , 4 ]. Epidemiological study has shown that about 10% of the population is affected by TMD, especially in 30-year-old women [ 5 ].…”