Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Associations between oral behaviors, temporomandibular disorder subtypes and psychological distress in adult women: a retrospective case-control study
1Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Stomatological Virtual Reality Engineering Research Center, College & Hospital of Stomatology, Guangxi Medical University, 530021 Nanning, Guangxi, China
2State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, Sichuan, China
3West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
DOI: 10.22514/jofph.2024.030 Vol.38,Issue 3,September 2024 pp.87-99
Submitted: 10 April 2024 Accepted: 28 June 2024
Published: 12 September 2024
*Corresponding Author(s): Xin Xiong E-mail: drxiongxin@scu.edu.cn
*Corresponding Author(s): Shanbao Fang E-mail: fangshanbao@gxmu.edu.cn
Oral behaviors and psychological distress are known to be related to temporomandibular disorders (TMDs). However, the relationship between various oral behaviors and specific TMD subgroups in adult women experiencing psychological distress is still unclear. To investigate the relationship between various oral behaviors and different TMD subgroups with different psychological distress states. A total of 210 female TMD patients were divided into 3 subgroups according to their symptoms: pain-related (PT), intra-articular (IT) and combined pain-related and intra-articular (CT). Another 70 participants without TMDs were recruited as the non-TMD (NT) control group. We used reduced Chinese versions of the Oral Behavior Checklist (OBC-Ch 8), including awake (OBC-Ch 6) and sleep-related activities, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) to assess oral behaviors and psychological distress. Differences in OBC scores among TMD subgroups were analyzed using Chi-square, Kruskal-Wallis H and post hoc tests, with significance set at p < 0.05. Oral behavior subscale scores significantly differed among TMD subgroups (p < 0.01). The OBC-Ch 8 scores of PT, IT and CT subjects were significantly higher than the NT group. PT and CT groups also had significantly higher GAD-7 and PHQ-9 scores. Sleep-related OBC scores of the PT, IT and CT groups were higher than those in the NT group, regardless of psychological states (p < 0.001). In psychologically distressed subjects, OBC-Ch 8 scores for PT and CT subgroups were significantly higher than those in the NT group. Oral behaviors are differentially associated with various TMD subgroups in female adults, and a correlation exists between individual psychological status and OBC scores.
Oral behaviors; Psychological distress; Temporomandibular joint disorders; Bruxism; TMD subgroups
Yu Zhong,Fang Luo,Xinbei Li,Shiya Zeng,Shuyuan Zhang,Jiarui Si,Xin Xiong,Shanbao Fang. Associations between oral behaviors, temporomandibular disorder subtypes and psychological distress in adult women: a retrospective case-control study. Journal of Oral & Facial Pain and Headache. 2024. 38(3);87-99.
[1] Xie C, Lin M, Yang H, Ren A. Prevalence of temporomandibular disorders and its clinical signs in Chinese students, 1979–2017: a systematic review and meta-analysis. Oral Diseases. 2019; 25: 1697–1706.
[2] Kapos FP, Exposto FG, Oyarzo JF, Durham J. Temporomandibular disorders: a review of current concepts in aetiology, diagnosis and management. Oral Surgery. 2020; 13: 321–334.
[3] Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. The New England Journal of Medicine. 2008; 359: 2693–2705.
[4] Yi Y, Zhou X, Xiong X, Wang J. Neuroimmune interactions in painful TMD: Mechanisms and treatment implications. Journal of Leukocyte Biology. 2021; 110: 553–563.
[5] Warzocha J, Gadomska-Krasny J, Mrowiec J. Etiologic factors of temporomandibular disorders: a systematic review of literature containing diagnostic criteria for temporomandibular disorders (DC/TMD) and research diagnostic criteria for temporomandibular disorders (RDC/TMD) from 2018 to 2022. Healthcare. 2024; 12: 575.
[6] Chow JC, Cioffi I. Effects of trait anxiety, somatosensory amplification, and facial pain on self-reported oral behaviors. Clinical Oral Investigations. 2019; 23: 1653–1661.
[7] Tang Y, Fan S, Yao Y, Xu LL, Cai B. Oral behavior characteristics of 540 patients suffering from temporomandibular disorders. Shanghai Journal of Stomatology. 2021; 30: 531–534. (In Chinese)
[8] Barbosa C, Manso MC, Reis T, Soares T, Gavinha S, Ohrbach R. Are oral overuse behaviours associated with painful temporomandibular disorders? A cross-sectional study in Portuguese university students. Journal of Oral Rehabilitation. 2021; 48: 1099–1108.
[9] Keela W, Itthikul T, Mitrirattanakul S, Pongrojpaw S. Awake and sleep oral behaviours in patients with painful temporomandibular disorders. International Dental Journal. 2024; 74: 138–145.
[10] Lövgren A, Ilgunas A, Häggman-Henrikson B, Elias B, Roudini OA, Visscher CM, et al. Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors. Journal of Evidence-Based Dental Practice. 2023; 23: 101888.
[11] Zlendić M, Vrbanović E, Tomljanović M, Gall Trošelj K, Đerfi KV, Alajbeg IZ. Association of oral behaviours and psychological factors with selected genotypes in pain-related TMD. Oral Diseases. 2024; 30: 1702–1715.
[12] Markiewicz MR, Ohrbach R, McCall WD Jr. Oral behaviors checklist: reliability of performance in targeted waking-state behaviors. Journal of Orofacial Pain. 2006; 20: 306–316.
[13] Slade GD, Fillingim RB, Sanders AE, Bair E, Greenspan JD, Ohrbach R, et al. Summary of findings from the OPPERA prospective cohort study of incidence of first-onset temporomandibular disorder: implications and future directions. The Journal of Pain. 2013; 14: T116–T124.
[14] Donnarumma V, Ohrbach R, Simeon V, Lobbezoo F, Piscicelli N, Michelotti A. Association between waking-state oral behaviours, according to the oral behaviors checklist, and TMD subgroups. Journal of Oral Rehabilitation. 2021; 48: 996–1003.
[15] Suvinen TI, Reade PC, Kemppainen P, Könönen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. The Journal of Pain. 2005; 9: 613–633.
[16] Salinas Fredricson A, Krüger Weiner C, Adami J, Rosén A, Lund B, Hedenberg-Magnusson B, et al. The role of mental health and behavioral disorders in the development of temporomandibular disorder: a SWEREG-TMD nationwide case-control study. Journal of Pain Research. 2022; 15: 2641–2655.
[17] Wu Y, Xiong X, Fang X, Sun W, Yi Y, Liu J, et al. Psychological status of TMD patients, orthodontic patients and the general population during the COVID-19 pandemic. Psychology, Health & Medicine. 2021; 26: 62–74.
[18] Dan R, Li J, Xie T, Luo M, Lau RS, Hu S, et al. Impact of different types of temporomandibular disorders on jaw functional limitation and psychological distress in orthodontic patients. Journal of Oral Rehabilitation. 2023; 50: 644–654.
[19] Zheng Y, Zhou X, Huang Y, Lu J, Cheng Q, Fan P, et al. Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders. Journal of Oral Rehabilitation. 2023; 50: 1373–1381.
[20] Ye C, Xiong X, Zhang Y, Pu D, Zhang J, Du S, et al. Psychological profiles and their relevance with temporomandibular disorder symptoms in preorthodontic patients. Pain Research & Management. 2022; 2022: 1039393.
[21] Donnarumma V, Cioffi I, Michelotti A, Cimino R, Vollaro S, Amato M. Analysis of the reliability of the Italian version of the oral behaviours checklist and the relationship between oral behaviours and trait anxiety in healthy individuals. Journal of Oral Rehabilitation. 2018; 45: 317–322.
[22] Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: report of a work in progress. Journal of Oral Rehabilitation. 2018; 45: 837–844.
[23] Manfredini D, Lobbezoo F. Sleep bruxism and temporomandibular disorders: a scoping review of the literature. Journal of Dentistry. 2021; 111: 103711.
[24] Ohlmann B, Waldecker M, Leckel M, Bömicke W, Behnisch R, Rammelsberg P, et al. Correlations between sleep bruxism and temporomandibular disorders. Journal of Clinical Medicine. 2020; 9: 611.
[25] Bartolucci ML, Incerti Parenti S, Bortolotti F, Della Godenza V, Vandi S, Pizza F, et al. Sleep bruxism and orofacial pain in patients with sleep disorders: a controlled cohort study. Journal of Clinical Medicine. 2023; 12: 2997.
[26] Yap AU, Dworkin SF, Chua EK, List T, Tan KB, Tan HH. Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients. Journal of Orofacial Pain. 2003; 17: 21–28.
[27] Yap AU, Zhang MJ, Zhang XH, Cao Y, Fu KY. Viability of the quintessential 5 temporomandibular disorder symptoms as a TMD screener. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2022; 133: 643–649.
[28] Sun R, Zhang S, Si J, Zhang L, Yang H, Ye Z, et al. Association between oral behaviors and painful temporomandibular disorders: a cross-sectional study in the general population. Journal of Pain Research. 2024; 17: 431–439.
[29] Knibbe W, Lobbezoo F, Voorendonk EM, Visscher CM, de Jongh A. Prevalence of painful temporomandibular disorders, awake bruxism and sleep bruxism among patients with severe post-traumatic stress disorder. Journal of Oral Rehabilitation. 2022; 49: 1031–1040.
[30] Yap AU, Marpaung C. Personality, psychosocial and oral behavioural risk factors for temporomandibular disorder symptoms in Asian young adults. Journal of Oral Rehabilitation. 2023; 50: 931–939.
[31] Medin Ceylan C, Cigdem Karacay B. The relationship between the oral behavioral checklist and the jaw functional limitation scale in temporomandibular joint pain. BMC Oral Health. 2023; 12: 112–117.
[32] Barrientos E, Pelayo F, Tanaka E, Lamela-Rey MJ, Fernández-Canteli A, de Vicente JC. Effects of loading direction in prolonged clenching on stress distribution in the temporomandibular joint. Journal of the Mechanical Behavior of Biomedical Materials. 2020; 112: 104029.
[33] Michelotti A, Cioffi I, Festa P, Scala G, Farella M. Oral parafunctions as risk factors for diagnostic TMD subgroups. Journal of Oral Rehabilitation. 2010; 37: 157–162.
[34] Glaros AG, Williams K, Lausten L. The role of parafunctions, emotions and stress in predicting facial pain. The Journal of the American Dental Association. 2005; 136: 451–458.
[35] Glaros AG, Williams K, Lausten L, Friesen LR. Tooth contact in patients with temporomandibular disorders. CRANIO: The Journal of Craniomandibular & Sleep Practice. 2005; 23: 188–193.
[36] Ohrbach R, Sharma S. Temporomandibular disorders: definition and etiology. Seminars in Orthodontics. 2023: 30: 237–242.
[37] Manfredini D, Ahlberg J, Aarab G, Bender S, Bracci A, Cistulli PA, et al. Standardised tool for the assessment of bruxism. Journal of Oral Rehabilitation. 2024; 51: 29–58.
[38] Su N, Liu Y, Yang X, Shen J, Wang H. Association of malocclusion, self-reported bruxism and chewing-side preference with oral health-related quality of life in patients with temporomandibular joint osteoarthritis. International Dental Journal. 2018; 68: 97–104.
[39] Melo G, Duarte J, Pauletto P, Porporatti AL, Stuginski-Barbosa J, Winocur E, et al. Bruxism: an umbrella review of systematic reviews. Journal of Oral Rehabilitation. 2019; 46: 666–690.
[40] Ekman A, Rousu J, Näpänkangas R, Kuoppala R, Raustia A, Sipilä K. Association of self-reported bruxism with temporomandibular disorders—Northern Finland Birth Cohort (NFBC) 1966 study. CRANIO: The Journal of Craniomandibular & Sleep Practice. 2023; 41: 212–217.
[41] Raphael KG, Sirois DA, Janal MN, Wigren PE, Dubrovsky B, Nemelivsky LV, et al. Sleep bruxism and myofascial temporomandibular disorders: a laboratory-based polysomnographic investigation. The Journal of the American Dental Association. 2012; 143: 1223–1231.
[42] Manfredini D, Ahlberg J, Aarab G, Bracci A, Durham J, Emodi-Perlman A, et al. The development of the Standardised Tool for the Assessment of Bruxism (STAB): an international road map. Journal of Oral Rehabilitation. 2024; 51: 15–28.
[43] Reis PHF, Laxe LAC, Lacerda-Santos R, Münchow EA. Distribution of anxiety and depression among different subtypes of temporomandibular disorder: a systematic review and meta-analysis. Journal of Oral Rehabilitation. 2022; 49: 754–767.
[44] Yao Y, Liu SS, Jin L, Zeng H, Jiang X, Fang ZY, et al. Mental health and jaw function of patients with anterior disc displacement with reduction. Journal of Oral Rehabilitation. 2024; 51: 677–683.
[45] Xu L, Cai B, Fan S, Lu S, Dai K. Association of oral behaviors with anxiety, depression, and jaw function in patients with temporomandibular disorders in china: a cross-sectional study. Medical Science Monitor. 2021; 27: e929985.
[46] Patel K, Eley KA, Cascarini L, Watt-Smith S, Larkin M, Lloyd T, et al. Temporomandibular disorders-review of evidence-based management and a proposed multidisciplinary care pathway. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2023; 136: 54–69.
Science Citation Index (SCI)
Science Citation Index Expanded (SCIE)
BIOSIS Previews
Scopus
Cumulative Index to Nursing and Allied Health Literature (CINAHL)
Top