Comparison of psychological states and oral health–related quality of life of patients with differing severity of temporomandibular disorders

Abstract

Background: Studies on temporomandibular disorder (TMD) severity in patient populations are scarce.Objectives: This study sought to compare the psychological states and oral healthrelated quality of life (OHRQoL) among patients with differing TMD severity. Methods: Adult patients (≥18 years old) with and without (controls) TMDs were recruited from the TMD/oro-facial pain centre and prosthodontics department, respectively. The presence and severity of TMDs were established with the Fonseca Anamnestic Index (FAI), and TMD diagnoses were confirmed with the Diagnostic Criteria for TMDs (DC/TMD). Psychological states and OHRQoL were examined with the Depression, Anxiety, Stress Scales-21 (DASS-21) and Oral Health Impact Profile for TMDs (OHIP-TMD). Data were subjected to chi-square, Kruskal-Wallis/Mann-Whitney U tests and Spearman's correlation (α = .05).Results: A total of 961 participants with a mean age of 32.99 ± 13.14 years (71.19% women) were assessed. Frequencies of the various TMD categories were as follows:no TMD/controls (12.07%), mild TMD (24.56%), moderate TMD (40.37%) and severe TMD (23.00%). The three most common TMD-related symptoms were TMJ noises, mouth opening difficulty and muscle pain. Participants with moderate/severe TMD presented a higher proportion of intra-articular and/or combined disorders. They reported significantly higher levels of depression, anxiety, stress and poorer OHRQoL than their counterparts with no/mild TMD (p < .001). Moderate-to-strong correlations were observed between FAI and DASS-21/OHIP-TMD scores (rs = 0.42-0.72). Conclusions:Patients with moderate/severe TMD had significantly higher levels of psychological disturbance and poorer OHRQoL. As OHRQoL and psychological states are correlated, psychological well-being must be considered when managing patients with moderate/severe TMDs.

Craniofacial Morphology of Orthodontic Patients with and without Temporomandibular Disorders: A Cross-Sectional Study

“…The mean age of TMD patients was significantly higher than that of patients without TMDs, which was consistent with the results reported by Yap et al [ 25 ]. This may be attributed to the high incidence of TMD symptoms in populations of middle age [ 26 ] or the pathological changes in the TMJ and masticatory muscles, which are easily affected by internal and external environmental factors after the period of growth.…”

“…This may be attributed to the high incidence of TMD symptoms in populations of middle age [ 26 ] or the pathological changes in the TMJ and masticatory muscles, which are easily affected by internal and external environmental factors after the period of growth. However, since only orthodontic patients were included in the present study, all patients (with and without TMDs) were younger than the population studied by Yap et al [ 25 ]. No difference was observed in gender distribution between the TMD group and the control group in the present study.…”

Preclinical models of deep craniofacial nociception and temporomandibular disorder pain

“…TMD symptoms are mild in nature, while some patients will progress to chronic pain, which could interfere with social life activities [ 7 , 8 ]. It is no doubt that alleviation of chronic pain is an important issue to elevate the quality of life [ 9 , 10 ]. Unfortunately, the basis for chronic pain is not fully understood, which could hamper the development of the treatments indicated by several reasons.…”

“…Further, the experimental procedures to identify the nociceptive responses in the deep craniofacial tissues are discussed in the preclinical models. Second, the involvements of affective factors in the deep craniofacial nociception are discussed, since psychological distress is one of the critical risk factors that exacerbate TMD pain [ 2 , 9 , 10 , 12 , 18 ].…”

Evaluation of the relationship between the occlusal vertical dimension and temporomandibular joint disorders

“…Many studies evaluate the quality of life correlations with TMD [30,31]. The literature proved that the severity of TMD was inversely related to the quality of life [32,33]. Also, tooth wear adversely affects the quality of life [34].…”