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Associations between caffeine consumption, anxiety, temporomandibular disorders, and oral behaviors in university students in Brazil—a cross-sectional study
1Department of Dentistry, School of Health Sciences, University of Brasília (UnB), 70910-900 Brasilia, Brazil
DOI: 10.22514/jofph.2026.061 Vol.40,Issue 5,September 2026 pp.65-73
Submitted: 02 April 2026 Accepted: 29 May 2026
Published: 12 September 2026
*Corresponding Author(s): Rodrigo Antonio de Medeiros E-mail: rodrigo.medeiros@unb.br
Background: This cross-sectional study investigated the associations between caffeine consumption, caffeine-related expectations, anxiety symptoms, painful temporomandibular disorder (TMD) symptoms, and oral behaviors in university students. Methods: Students from the Faculty of Health Sciences at the University of Brasília completed a self-administered questionnaire assessing their sociodemographic characteristics, caffeine consumption frequency, expected effects of caffeine, anxiety symptoms, painful TMD symptoms, and oral behaviors. Associations between categorical variables were analyzed using the chi-square or Fisher’s exact tests, and correlations between caffeine consumption and expectancy domains were assessed using Spearman’s correlation coefficient. Statistical analyses were performed at a significance level of 5%. Results: A total of 182 students participated in this study. Painful TMD symptoms were significantly more prevalent among students with severe anxiety (p < 0.001). A higher prevalence was also observed among female participants and those who reported frequent oral behaviors. Oral behaviors were significantly associated with both anxiety symptoms and female sex (p < 0.001). No significant association was found between overall caffeine consumption and oral behaviors. However, daily black coffee consumption was significantly associated with severe anxiety (p < 0.001). Additionally, specific types of caffeinated products were positively correlated with distinct expectations about their effects, such as increased energy, dependence, and mood enhancement. Conclusions: Although overall caffeine consumption was not directly associated with oral behaviors or painful TMD symptoms, daily black coffee intake was associated with higher anxiety levels in this study sample. These findings suggest a possible association between black coffee consumption, anxiety symptoms, and painful TMD-related outcomes; although causality cannot be established because of the observational design of the study.
Temporomandibular disorders; Anxiety; Caffeine; Students
Ana Luiza Azevedo Gontijo, Monalisa Teixeira Santos De Macedo, Stefany Joaquina Sousa Farias, Edivar Ximenes De Aragao Junior, Karoline Bittencourt Mendes Leitão, Evelyn Mikaela Kogawa, Rodrigo Antonio De Medeiros. Associations between caffeine consumption, anxiety, temporomandibular disorders, and oral behaviors in university students in Brazil—a cross-sectional study. Journal of Oral & Facial Pain and Headache. 2026; 40(5): 65-73. doi: 10.22514/jofph.2026.061
[1] Park Y, Yoon S, Yoon JH, Yoo JJ. Association between temporomandibular disorders and mental and behavioural disorders—a nationwide population-based cross-sectional study. Clinical Oral Investigations. 2025; 29: 234.
[2] 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.
[3] Verhoeff MC, Lobbezoo F, Ahlberg J, Bender S, Bracci A, Colonna A, et al. Updating the bruxism definitions: report of an international consensus meeting. Journal of Oral Rehabilitation. 2025; 52: 1335–1342.
[4] Bueno CH, Pereira DD, Pattussi MP, Grossi PK, Grossi ML. Gender differences in temporomandibular disorders in adult populations: a systematic review and meta-analysis. Journal of Oral Rehabilitation. 2018; 45: 720–729.
[5] Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, et al. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clinical Oral Investigations. 2021; 25: 441–453.
[6] Yap AU, Tan SHX, Marpaung C. Temporomandibular disorder symptoms in young adults: three-dimensional impact on oral health-related quality of life. Journal of Oral Rehabilitation. 2022; 49: 769–777.
[7] Al-Khudhairy MW, Alkhamsi Alqahtani GB, Altwijri AMA, Aladwani RA, AlYousof DH, AlNajdi LN, et al. Sleep, caffeine, BMI, and pressure pain threshold in temporomandibular disorder patients: an observational study. Cureus. 2024; 16: e57703.
[8] Dos Santos EA, Peinado BRR, Frazão DR, Né YGS, Fagundes NCF, Magno MB, et al. Association between temporomandibular disorders and anxiety: a systematic review. Frontiers in Psychiatry. 2022; 13: 990430.
[9] Soares LFF, Castro JV, Andrade LS, Ramos MC, Almeida DAF, Haddad MF. Correlation between the event of the COVID-19 pandemic and symptoms of anxiety, depression and temporomandibular disorder in university students: cross-sectional study. Brazilian Journal of Pain. 2023; 6: 269–276.
[10] Da-Cas CD, Valesan LF, Nascimento LPD, Denardin ACS, Januzzi E, Fernandes G, et al. Risk factors for temporomandibular disorders: a systematic review of cohort studies. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2024; 138: 502–515.
[11] Nehlig A. Is caffeine a cognitive enhancer? Journal of Alzheimer’s Disease. 2010; 20: S85–S94.
[12] Smith A. Effects of caffeine on human behavior. Food and Chemical Toxicology. 2002; 40: 1243–1255.
[13] Roehrs T, Roth T. Caffeine: sleep and daytime sleepiness. Sleep Medicine Reviews. 2008; 12: 153–162.
[14] Landolt HP. Sleep homeostasis: a role for adenosine in humans? Biochemical Pharmacology. 2008; 75: 2070–2079.
[15] Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al.; International RDC/TMD Consortium Network, International Association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of Oral & Facial Pain and Headache. 2014; 28: 6–27.
[16] Mendes GF, Reis CEG, Nakano EY, Zandonadi RP. Brief version of caffeine expectancy questionnaire in Brazil. Frontiers in Nutrition. 2021; 8: 695385.
[17] Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: past, present, future. Journal of Dental Research. 2016; 95: 1093–1101.
[18] Ohrbach R, Knibbe W. Diagnostic criteria for temporomandibular disorders (DC/TMD): scoring manual for self-report instruments. 2021. Available at: https://inform-iadr.com/new/wp-content/uploads/2024/01/DC-TMD-Self-report-Instrument-Scoring-Manual_2021_03_30.pdf (Accessed: 15 June 2023).
[19] Flor H, Turk DC. Chronic pain: an integrated biobehavioral approach. 1st edn. IASP Press: Seattle. 2011.
[20] Chen L, Zhang S, Tan Y, Zheng Y, Fang S, Yi Y, et al. Anxiety mediates association between sex and jaw function limitation in temporomandibular disorder patients from China. Frontiers in Neurology. 2024; 15: 1398788.
[21] Velly AM, Gornitsky M, Philippe P. Contributing factors to chronic myofascial pain: a case–control study. Pain. 2003; 104: 491–499.
[22] Juliano LM, Evatt DP, Richards BD, Griffiths RR. Characterization of individuals seeking treatment for caffeine dependence. Psychology of Addictive Behaviors. 2012; 26: 948–954.
[23] Meredith SE, Juliano LM, Hughes JR, Griffiths RR. Caffeine use disorder: a comprehensive review and research agenda. Journal of Caffeine Research. 2013; 3: 114–130.
[24] Woo A, Ratnayake G. Sleep and pain management: a review. Pain Management. 2020; 10: 261–273.
[25] Spriet LL. Exercise and sport performance with low doses of caffeine. Sports Medicine. 2014; 44: S175–S184.
[26] Goldstein ER, Ziegenfuss T, Kalman D, Kreider R, Campbell B, Wilborn C, et al. International Society of Sports Nutrition position stand: caffeine and performance. Journal of the International Society of Sports Nutrition. 2010; 7: 5.
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