Psychological distress and well-being: their association with temporomandibular disorder symptoms

Analysis of Temporomandibular Disorders, Bruxism and Well-Being in Patients With Fibromyalgia Syndrome: A Case-Control Study

OBJECTIVES

To analyse temporomandibular disorders (TMD), bruxism and well-being in patients with fibromyalgia and compare these outcomes with a control group.

METHOD

Diagnostic criteria for the assessment of TMD, bruxism and well-being were used in a clinic context including patients with fibromyalgia (n = 71) and a control group of healthy subjects (n = 151). Participants completed an online questionnaire measuring temporomandibular pain, headache attributed to TMD, jaw locking, joint sounds, headache to bruxism, potential sleep bruxism, potential awake bruxism, jaw functional limitation scale 8 (JFLS-8), generalised anxiety disorder scale 7, oral health impact profile scale 14, World Health Organization well-being index (WHO-5) and Pittsburgh sleep quality index (PSQI).

RESULTS

TMD and bruxism were significantly associated with the type of population (χ2 = 8.77-57.62; p < 0.05; ES = 0.20-0.51). Fibromyalgia patients showed higher prevalence (% values) than control group in temporomandibular pain, headache attributed to TMD, jaw locking, headache attributed to potential bruxism, sleep bruxism and awake bruxism. However, there was a greater prevalence of joint sounds in the control group compared to the fibromyalgia group. Also, fibromyalgia patients scored significantly higher (p < 0.001) on JFLS-8, GAD-7, OHIP-14 and PSQI with a large effect size (ES = 0.51-0.73), while WHO-5 scores were significantly lower (ES = 0.58).

CONCLUSION

Patients with fibromyalgia had greater prevalence than the control group in TMJ pain, headache attributed to TMD, jaw locking, headache attributed to bruxism, sleep bruxism and awake bruxism. Another main finding was that patients with fibromyalgia had greater jaw functional limitation, generalised anxiety and impact of oral health on an individual's life. In addition, fibromyalgia patients showed lower sleep quality and well-being index.

Temporomandibular disorder and somatic symptoms: Relations to 'fear of missing out' and other negative emotional states

OBJECTIVE

The association between the 'fear of missing out (FOMO)' and physical symptoms has not been widely explored. This study aimed to investigate the relationship between FOMO and other negative emotions with Temporomandibular disorder (TMD) and somatic symptoms in young adults. The correlations between the various physical and emotional variables were also established.

MATERIAL AND METHODS

TMD and somatic symptoms were appraised with the Short-form Fonseca Anamnestic Index, quintessential five TMD symptoms of the Diagnostic Criteria (DC)/TMD, and Patient Health Questionnaire-15. FOMO and other negative emotional states were assessed with the FOMO Scale and Depression, Anxiety, Stress Scales-21 (DASS-21). Data were evaluated using non-parametric tests/correlation and regression analysis (α = 0.05).

RESULTS

While only negative affectivity (total DASS), anxiety, and stress differed significantly between those without and with TMDs, significant variances in FOMO and all DASS-21 constructs were discerned between individuals without and with somatization.  Conclusions: Individuals with orofacial pain and more severe somatic symptoms have higher levels of negative emotions including FOMO. While somatization increased the prospect of TMDs, being female, presence of TMDs, and negative affectivity were risk factors for somatization in young adults.

CLINICAL RELEVANCE

Asian young adults appear to be disposed to somatization, and TMDs may be a form of functional somatic syndromes. Recognition of somatic symptoms and emotional distress, including FOMO, is essential for person-centric TMD care.

Temporomandibular disorder pain in older adolescents-young adults: Interrelationship with somatic burden, mental ill-being, and well-being

OBJECTIVES

The associations of Temporomandibular disorder (TMD) pain with somatic symptoms, mental ill-being/distress, and well-being were explored, along with the mental correlates of TMD (TS) and somatic symptom (SS) burden in older adolescents-young adults.

METHODS

TMD/somatic symptoms were appraised with the five quintessential symptoms (5Ts) of the DC/TMD/Somatic Symptom Scale-8, whereas mental distress/well-being was assessed with the Depression, Anxiety, Stress Scales-21/Scales of Psychological Well-being-18. Data were examined using Chi-square/non-parametric tests and multivariate analyses (α = .05).

RESULTS

Among the 366 participants, 51.4%, 28.1%, 6.8%, and 13.7% had no TMD (NT), TMD pain (TP), TMD dysfunction (TD), and combined TMD (CT) respectively. Though mental distress varied substantially (CT, TP>NT, TD), no significant differences in well-being were discerned. SS burden, but not TS burden, was moderately correlated to distress.

CONCLUSIONS

The prospect of TMD pain was increased by being female, depressed, and anxious but reduced by "positive relations with others" and "self-acceptance".

Correlates between temporomandibular disorder severity, emotional distress, and eudaimonic well-being among young adults

OBJECTIVES

This study examined the correlates between severity of temporomandibular disorders (TMDs), emotional distress, and eudaimonic well-being.

SUBJECTS AND METHODS

TMD severity, negative emotions, and eudaimonia were assessed with the Fonseca Anamnestic Index (FAI), Depression, Anxiety, Stress Scales-21 (DASS-21), and Psychological Well-being Scale-18 (PWBS-18) in a cohort of community young adults. Statistical evaluations were done with non-parametric tests/correlation and multivariate regression analyses (α = 0.05).

RESULTS

Amongst the 873 participants (mean age 19.8 ± 1.66 years), 40.7%, 49.0%, and 10.3% had no (NT), mild (MT), and moderate-to-severe (ST) TMD, respectively. Significant differences in total-DASS, depression, anxiety, and stress were ST ≥ MT > NT. Significant variances in total-PWSB and self-acceptance were NT > MT > ST while that for environmental mastery, positive relations, and purpose in life were NT > MT, ST. An inverse relationship was discerned between total-DASS and total-PWBS (correlation coefficient = -0.54). The prospect of ST was increased by anxiety but reduced by positive relations and self-acceptance.

CONCLUSIONS

Young adults with mild and moderate-to-severe TMD experienced substantially higher emotional distress and lower eudaimonia than those with no TMD. As emotional distress and eudaimonic well-being are interrelated, positive psychological interventions may be beneficial for managing TMD-related psychosocial disabilities.

Personality, psychosocial and oral behavioural risk factors for temporomandibular disorder symptoms in Asian young adults

BACKGROUND

The relation between personality, psychosocial factors, somatisation, andoral behaviours as risk factors to temporomandibular disorder symptoms have notbeen well established.

OBJECTIVES

This study examined the association of temporomandibular disorder (TMD) symptoms with personality traits, psychological distress, somatisation and oral behaviours. The psychosocial and oral behavioural risk factors for TMD symptoms were also established in Asian young adults.

METHODS

Participants were recruited from a large private University. Based on the quintessential five TMD symptoms (5Ts) of the DC/TMD, the participants were stratified into those with no (NT), painful (PT), dysfunctional (DT) and mixed (MT) TMD symptoms. Personality traits, psychological distress, somatisation and oral behaviours were evaluated with the Big Five Inventory-10 (BFI-10), Depression, Anxiety, Stress Scales-21 (DASS-21), Patient Health Questionnaire-15 (PHQ-15) and Oral Behaviours Checklist (OBC) accordingly. Data were examined using Kruskal-Wallis/Mann-Whitney U and Chi-squared tests, as well as multivariate logistic regression analysis (α = .05).

RESULTS

Of the 420 young adults (mean age 22.7 ± 1.1 years) evaluated, 41.4% had no TMD symptoms, while 17.4%, 20.0% and 21.2% reported PT, DT and MT, respectively. Though personality traits did not vary notably, participants with MT and PT had significantly higher levels of negative affectivity, anxiety and stress than the NT group. Moreover, those with MT and PT presented significantly greater somatisation and more oral behaviours than the DT and NT groups. Multivariate regression analyses indicated that anxiety, somatisation, sleep-related and waking-state nonfunctional oral activities were associated with painful and/or dysfunctional TMD symptoms.

CONCLUSIONS

Except for sleep-related oral activity, psychosocial and oral behavioural risk factors differed for painful, dysfunctional and mixed TMD symptoms in Asian young adults.