Temporomandibular disorders in an adult population in northern Norway: A cross-sectional study

Temporomandibular disorder pain is associated with increased sick leave and reduced health related quality of life

BACKGROUND

Temporomandibular disorders (TMD) are the most common reason for chronic pain in the orofacial area and significantly impact the lives of those affected. The role of lifestyle factors in TMD, however, remains less explored. This cohort study aims to estimate TMD prevalence by addressing potential selection biases and to evaluate the association between TMD and lifestyle factors with a specific focus on sick leave and health related quality of life.

METHODS

By linking data on TMD in the general population in Västerbotten, northern Sweden (n = 180,000) to health survey data (n = 120,000), information on sociodemographic factors and quality of life was available for 52,961 individuals (50.6% women) with a mean age of 53 years. We applied inverse probability weighting to adjust for selection bias and Poisson regression to explore associations with TMD.

RESULTS

TMD prevalence was 9.2% during the study period, being higher in women (12.9%) than men (5.4%). Weighting for varying visiting frequencies did not affect TMD prevalence (average difference 0.4% points). Individuals with TMD, especially women, reported more sick leave and use of pain medication, with a significant association between TMD and increased sick leave (prevalence ratio 1.89, 95% CI: 1.78-2.01) among both women and men. In addition, TMD was associated with a lower health related quality of life (p < 0.001).

CONCLUSION

The association of TMD with sick leave highlights the condition's profound impact on the lives of affected individuals. These findings underscore the influence of TMD on work life and the burden of TMD on the societal level.

SIGNIFICANCE STATEMENT

The findings provide insight into how TMD affect individuals, by incorporating lifestyle factors, social determinants and the impact of sick leave at a population level. By incorporating these areas into the study of TMD, we can deepen our understanding of how TMD affects individuals' lives. This approach may also create opportunities to develop more comprehensive strategies to address TMD, focusing on broader implications beyond the clinical symptoms.

Comparison of symptoms, signs and magnetic resonance imaging in children aged 5-18 years with temporomandibular joint disease

BACKGROUND

Temporomandibular joint diseases (TMD) are an important clinical condition in childhood as in adults. There is variation in the frequency and distribution of complaints in children about this disorder.

MATERIALS AND METHODS

This study was conducted on 407 children aged 5-18 years. Patients with dentofacial function problems, trauma, history of surgery, and malignancy were excluded from the study. Patients with temporomandibular magnetic resonance imaging in their records were classified as normal, reduction disc displacement and non-reduction disc displacement.

RESULTS

Patients symptoms were click (77.2%), pain (71.5%), headache (61.2%), bruxism (31.9%), locking (28%), difficulty in mouth opening (24.3%). The most common clinical findings are normal mouth opening (62.2%) and deviation (44.9%). When the MR results were examined, 55.1% of female and 66.6% of male were observed to be normal, and this statistically shows that males have more normal MR findings.

CONCLUSION

TMD are also observed in children. Clinical history and findings are helpful in diagnosis, but the contribution of imaging methods may be limited. If head and neck pain is detected in children, TMD should be kept in mind.

Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients

Objective. To survey the clinical manifestations and imaging features of temporomandibular disorders (TMD) and analyze the risk factors for pathogenesis/prognosis through a case-control study based on psychogenic factors of patients. Methods. According to the inclusion criteria, 200 adult patients were randomly enrolled from the maxillofacial department of our hospital from January 2020 to May 2021, including 100 patients with TMD as the study group and 100 healthy patients as the control group. The study group can be assigned into four subgroups according to their clinical manifestations: (1) articular area or/and masticatory muscle pain group, (2) mandibular movement abnormality group, (3) joint murmur group, and (4) two or more symptom groups. Based on the study of psychogenic factors of patients, the clinical manifestations and imaging features of TMD were determined, and the risk factors for pathogenesis/prognosis were analyzed. Results. The distribution of psychological status in the TMD group was higher than that in the control group ( $P<0.05$ ). The distribution of anxiety, depression, and somatic symptoms in the TMD group was significantly different from that in the control group ( $P<0.05$ ). Anxiety, depression, and somatic symptoms were the risk factors for TMD. Compared with the control group, the incidence of abnormal MRI images in patients with temporomandibular disorders was significantly different ( $P<0.05$ ). There were significant differences in psychological status (anxiety, depression, and somatic symptoms) among the three groups ( $P<0.05$ ). Anxiety, depression, and somatic symptoms were the risk factors for abnormal mandibular movement and joint tremor and murmur ( $P<0.05$ ). Somatic symptoms were the risk factors for various clinical symptoms of TMD ( $P<0.05$ ). Depression was the risk factor for pain ( $P<0.05$ ). Conclusion. In patients with TMD, MRI can early identify disc abnormalities and other related imaging features, which is helpful for more comprehensive clinical evaluation and treatment of TMD patients. There exhibits no significant difference in psychological status (anxiety, depression, and somatic symptoms) of patients with different clinical symptoms, and abnormal psychological status may be one of the risk factors leading to different clinical symptoms and development of different types of TMD patients.