Assessing stress associated with temporomandibular joint disorder through Fonseca's anamnestic index among the Saudi physicians

Validity and reliability of the Turkish Version of the Oral Behaviors Checklist

OBJECTIVE

The aim of this study was to investigate the validity and reliability of the Turkish version of the Oral Behavior Checklist (OBC-TR).

MATERIALS AND METHODS

The study included 223 patients with temporomandibular disorders (TMDs) and 94 individuals without TMD. Face and content validity were analyzed. Structural (with confirmatory factor analysis [CFA]), convergent (with pain intensity, Fonseca Anamnestic Index [FAI], Hospital Anxiety and Depression Scale [HADS], and Oral Health Impact Profile [OHIP-14]), divergent (with active pain-free maximum mouth opening [MMO]), and discriminant validity were investigated to evaluate the construct validity. Cronbach's alpha for internal consistency and the intraclass correlation coefficient (ICC) for test-retest reliability were computed.

RESULTS

Face and content validity were satisfactory. The CFA has verified the structural validity of the OBC-TR. Strong associations between the OBC-TR score and pain intensity (r = 0.88), FAI (r = 0.90), HADS (r = 0.82-0.86), and OHIP-14 (r = 0.83) scores, and MMO (r = -0.85) verified the convergent and divergent validity of the OBC-TR. Concerning discriminant validity, the OBC-TR discriminated between patients with TMD and individuals without TMD (p < 0.05). Internal consistency (Cronbach's alpha = 0.89) and test-retest reliability (ICC = 0.91) were satisfactory.

CONCLUSION

The OBC-TR is a valid and reliable instrument to measure the frequency of oral parafunctional behaviors in Turkish-speaking patients with TMD.

Prevalence of Temporomandibular Disorders Between 2015-2021: A Literature Review

The prevalence of temporomandibular disorder (TMD) is significantly high around the world. We conducted a literature review to determine the prevalence of TMD globally and in Saudi Arabia based on published studies. This review article collected 35 full-text articles after searching PubMed for TMD prevalence between 2015-2021. Assessing the prevalence of TMDs is important for several reasons, including providing an overview of the incidence of such disorders, educating the community, clarifying the gender and age group with the highest prevalence, establishing a program to prepare specialists to treat these disorders, and identifying the appropriate number of specialists by comparing TMD prevalence to Saudi Arabia's census. Out of 35 selected articles, thirty studies were done outside Saudi Arabia, and five were local. Less than 40% prevalence of TMD has been reported with associated factors such as gender, psychological status, and age. The female gender has shown a higher TMD rate than the male gender. Some authors have suggested conducting a temporomandibular joint (TMJ) assessment in the pediatric clinic. Moreover, TMD screening is an important tool for every patient visiting the dental clinic to assess TMJ status and treat TMD at early stages, especially in non-painful cases.

Temporomandibular disorder prevalence and its association with oral parafunctions, neck pain, and neck function in healthcare students: A cross-sectional study

OBJECTIVE

To determine the temporomandibular disorder (TMD) prevalence in female students and to assess its association with oral parafunctions, neck pain, and function.

METHODS

One hundred forty-four participants were included. The severity of TMD was assessed with Fonseca's Anamnestic Index (FAI). The oral parafunctions were self-reported with the Oral Behaviors Checklist (OBC). Neck pain and neck function were recorded with the Core Outcome Measure Index (COMI). The Spearman correlation analysis was used for statistical analysis.

RESULTS

Seventy participants (48.6%) had mild TMD. All participants had a positive OBC score, which indicated an oral parafunction. A moderate correlation between TMD and oral parafunctions (p < 0.001) was detected.

DISCUSSION

TMD is common in female healthcare students, and its presence is associated with oral parafunctions, neck pain, and function. It is recommended to evaluate oral health habits and neck pain and function in females with TMD.

Correlations Between Mandibular Asymmetries and Temporomandibular Disorders: A Systematic Review

Objective

This systematic review aimed to investigate the correlation between mandibular asymmetry and temporomandibular disorders (TMDs).

Materials and Methods

A systematic search of the published literature was performed in electronic databases such as PubMed (MEDLINE), Scopus, Web of Science, Cochrane, Google Scholar, Clinicaltrials.gov, and Saudi Digital Library. Gray literature was searched through System for Information on Grey Literature through OpenGrey. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed in the investigation. The focussed question according to PICO format was: "does the mandibular asymmetry contribute to temporomandibular disorders"? Eligibility criteria included clinical trials (CTs), observation studies, cross-sectional and cohort studies in English that investigated mandibular asymmetries and TMD among patients. Blind and duplicate study selection, data extraction, and risk of bias assessment were carried out.

Results

The initial search resulted in 1906 articles, of which 11 (8 CTs, 1 cross-sectional, 1 retrospective, and 1 observational) studies were selected for qualitative synthesis after fulfilling the eligibility criteria.

Conclusion

Most of the studies included in this review showed either very high risk or high risk of bias. Despite the low certainty of evidence, the current study indicated a likely relationship between mandibular asymmetries and TMDs.

Evaluation of temporomandibular disorders among dental students of Saudi Arabia using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): a cross-sectional study

BACKGROUND

Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters.

METHODS

A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components.

RESULTS

The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008).

CONCLUSION

Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.

Prevalence of temporomandibular joint disorder in the Lebanese population, and its association with depression, anxiety, and stress

Background

The objectives of this study were to study the prevalence of temporomandibular joint disorder (TMD) and its association with anxiety, depression, and stress among the general Lebanese population as well as in a sample of patients recruited from an otolaryngologist clinic.

Methods

A cross-sectional study was conducted between September 2018 and December 2019, which enrolled 459 participants from all districts of Lebanon (sample 1) and 37 patients from the otolaryngologist clinic at the Eye and Ear Hospital (sample 2). The temporomandibular disorder screening checklist was used to screen for temporomandibular joint disorder. The Fonseca’s anamnestic index was used to assess for temporomandibular joint disorder related signs and symptoms, as well as for symptoms severity.

Results

The results showed that 19.7% of the general Lebanese population had TMD, from which 55.9% were female. In contrast, 59.5% of patients in the sample recruited from the clinic were found to have TMD. Higher stress, anxiety, and depression scores were associated with higher temporomandibular disorder severity score (B = 0.23; B = 0.10 and B = 0.10 respectively). Patients in the sample recruited from the clinic had higher mean stress (20.75 vs 11.43), anxiety (12.46 vs 5.78), depression (13.24 vs 6.52), and temporomandibular disorder severity scores (59.5% vs 19.7%) than the general population.

Conclusion

Temporomandibular joint disorder appears to be associated significantly with depression, anxiety, and stress and remains largely underdiagnosed in the general population.