Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population

Abstract

Background

Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse.

Objective

This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population.

Methods

A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history.

Results

A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P<0.01). The behaviors most strongly associated with PT were “Hold or jut jaw forward/to the side” (OR:4.478), “Hold, tighten or tense muscles without clench” (OR:3.343) and “Hold jaw in rigid or tense position” (OR:3.209).

Conclusion

The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.

Keywords:

• oral behaviors
• painful temporomandibular disorders
• Temporomandibular Joint
• general population
• cross-sectional study

Abbreviations

TMD, temporomandibular disorders; PT, painful TMD; 5Ts, the 5 major TMD symptoms; TMJ, temporomandibular joint; TNF, tumor necrosis factor; IL-1, interleukin-1; PG, prostaglandin; OSA, obstructive sleep apnea.

Ethics Approval and Informed Consent

This cross-sectional study was approved by the Institutional Review Board of West China Hospital of Stomatology (Approval no. WCHSIRB-D-2022-118) and was conducted in conformity to the Declaration of Helsinki. Consent was obtained from all study subjects.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by China Postdoctoral Science Foundation (Grant number 2023M732464), Technology Innovation Project of Science and Technology Bureau of Chengdu (grant number 2022-YF05 −01691-SN) and Clinical Research Project of West China Hospital of Stomatology, Sichuan University (grant number LCYJ-2023-YY-2).