Temporomandibular disorder symptoms in young adults: Three‐dimensional impact on oral health‐related quality of life

Abstract

Background:The impact of temporomandibular disorders on functional, pain, and psychosocial aspect of patients' quality of life needed to be assessed.Objectives: This study examined the three-dimensional impact of pain-related and/ or intra-articular Temporomandibular disorder (TMD) symptoms and ascertained the inter-relationships between the functional, pain, and psychosocial aspects of oral health-related quality of life (OHRQoL). Methods: Young adults were enlisted from a local university and TMD symptoms were assessed with the Diagnostic Criteria for TMDs Symptom Questionnaire (DC/ TMD-SQ). Participants were stratified into those with no (NT), pain-related (PT), intraarticular (IT), and mixed (MT) TMD symptoms. OHRQoL was examined using the Oral Health Impact Profile-14 (OHIP-14), and dimensional effects (oral function [OF], orofacial pain [OP], and psychosocial impact [PI]) were established subsequently. Data were evaluated with Kruskal-Wallis, Dunn, and Wilcoxon signed-rank tests (α = .05). Results:The mean age of the participants (n = 1205) was 7 ± 1.3 years (71.8% women).While 42.2% reported no TMD symptoms, 22.3%, 16.9%, and 18.5% had PT, IT, and MT accordingly. The MT, PT, and IT groups presented higher total OHIP-14 and dimension scores than the NT group (p < .01). Scores were also significantly different between the MT and IT groups except for OF. For all TMD groups, the ranking of dimensional impact was OP > PI > OF, and associations between the OP and PI dimensions were the strongest (correlation coefficient [r s ] = .57-.76). Conclusions: Young adults with PT and/or IT symptoms have poorer OHRQoL, especially in the OP and PI dimensions, which were moderate to strongly correlated. The use of the three dental Patient-reported Outcome (dPRO) dimensions could provide construct equivalency among OHRQoL measures. K E Y W O R D S dental patient-reported outcome measures, dental patient-reported outcomes, oral healthrelated quality of life, temporomandibular disorders How to cite this article: Yap AU, Tan SHX, Marpaung C. Temporomandibular disorder symptoms in young adults: Three-dimensional impact on oral health-related quality of life.

Correlates of jaw functional limitation, somatization and psychological distress among different temporomandibular disorder diagnostic subtypes

“…6,7 Difficulties eating, chewing, speaking, yawning and making facial/emotional expressions accompanying TMDs can negatively affect the health, well-being, and quality of life of individuals. 1,[7][8][9] The functional status of the masticatory system is often assessed using the Jaw Functional Limitation Scale (JFLS). 7 It was developed to address issues with earlier jaw limitation measures, such as the Mandibular Functional Impairment Questionnaire (MFIQ) and Research Diagnostic Criteria for TMDs (RDC/TMD) functional limitation checklist, including inadequate item definitions, overlapping item content across functional and psychosocial domains, and unknown generalizability across orofacial conditions.…”

“…[14][15][16][17][18][19][20] As the aforementioned factors are also interrelated and linked to somatization and emotional disturbance, the relationship of functional jaw limitations with somatic symptoms and psychological distress warrants investigation. [21][22][23][24][25][26][27] East Asians, which consists of Chinese, Japanese and Koreans, appear to be more susceptible to somatization (the tendency to emphasize somatic symptoms when experiencing psychological distress) than Westerners due to various socio-cultural factors. [28][29][30][31] The plethora of psychosocial connotations associated with the functions of the jaw/mouth makes it an ideal anatomic site for the symbolic portrayal of psychological distress.…”

“…This phenomenon was also observed in other clinical as well as non-clinical samples and had been ascribed to central sensitization (an amplified central nervous system response to peripheral nociception and sensory stimuli). 25,[46][47][48][49] Central sensitization was also posited to be the underlying mechanism for functional somatic syndromes such as tension-type headaches, fibromyalgia and irritable bowel syndrome.…”

Psychological characteristics of young adults with temporomandibular disorders, somatization and combined conditions: A multidimensional evaluation

“…21 Nonetheless, many TMD sufferers have combined joint and muscle symptoms. 26,27 Young adulthood is the unique development period when young people are traditionally expected to shoulder adult responsibilities and engage in work and/or higher education. Young adults constitute a substantial proportion of TMD patients and their mental health appears to have declined over the past decade.…”

“…Though patients with joint and muscle conditions had comparable psychological and coping profiles, their personality predictors differed 21 . Nonetheless, many TMD sufferers have combined joint and muscle symptoms 26,27 …”