Influence of Psychosocial Factors and Habitual Behavior in Temporomandibular Disorder–Related Symptoms in a Working Population in Japan

Abstract

Background: The symptoms of temporomandibular disorders (TMD) are directly influenced by numerous factors, and it is thought that additional factors exert indirect influences. However, the relationships between TMD-related symptoms (TRS) and these contributing factors are largely unknown. Thus, the goal of the present study was to investigate influences on TRS in a working population by determining the prevalence of TRS, analyzing contributing factors, and determining their relative influences on TRS.Materials and Methods: The study subjects were 2203 adults who worked for a single company. Subjects completed a questionnaire assessing TRS, psychosocial factors (stress, anxiety, depressed mood, and chronic fatigue), tooth-contacting habit, and sleep bruxism-related morning symptoms, using a 5-point numeric rating scale. Our analysis proceeded in 2 phases. First, all variables of the descriptor were divided into parts by using an exploratory factor analysis. Second, this factorial structure was verified by using a confirmatory factor analysis with structural equation modeling.Results: Of 2203 employees, 362 reported experiencing TRS (16.4%). Structural equation modeling generated a final model with a goodness of fit index of 0.991, an adjusted goodness of fit index of 0.984, and a root mean square error of approximately 0.021. These indices indicate a strong structural model. The standardized path coefficients for “habitual behavioral factors and TRS,” “psychosocial factors and habitual behavioral factors,” “psychosocial factors and TRS,” and “gender and habitual behavior factors” were 0.48, 0.38, 0.14, and 0.18, respectively.Conclusions: Habitual behavioral factors exert a stronger effect on TRS than do psychosocial factors.

Disfunção temporomandibular e dor craniocervical em profissionais da área da enfermagem sob estresse no trabalho

“…In this study, 30.23% of the individuals were diagnosed with this dysfunction. It is highlighted that TMD has multifactorial etiology, being stress as one of the predisposing factors 1,19 .…”

“…To each of the answers of the questionnaire, scores from 4 to 1 were attributed from highest to lowest frequency. The possibilities of answers varied from frequently (4) to never (1). Therefore, the cut-off for the "demand" dimension was established as follows: low demand: scores from 5 to 14; high demand: scores from 15 to 20.…”

“…bruxism), trauma in the orofacial region 4 , and psychosocial factors are among the risk factors 5 . In relation to men, women have significantly higher probability of being diagnosed with TMD 1,5 . In addition to that, TMD is frequently associated to headache and muscular pain in the neck 6,7 .…”

Aspectos clínicos e psicossociais avaliados por critérios de diagnóstico para disfunção temporomandibular

“…Women are more likely to be diagnosed with TMD than men 9,10 . TMD occurs predominantly during the productive years, in patients aged 20-50 years 3,11 .…”

“…Besides being the possible triggers of TMD 2,3,10 , the psychosocial factors are associated to the severity and persistency of clinical symptoms. Those factors influence the patients response to treatment 5,10 , and may be important outcome predictors 18 .…”