Abstract
BackgroundTemporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters.MethodsA total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components.ResultsThe overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008).ConclusionDental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.
Highlights
Temporomandibular disorders (TMD) are a broad category of conditions arising from the various com‐ ponents of the temporomandibular joint complex
Pain arising from areas such as jaw, the temple, or in front of the ear was the most commonly (76.92%) reported symptom followed by joint noise (30.76%)
The present study has an edge over other studies in Saudi Arabia, as it is first of its kind which has evaluated the male and female dental undergraduates for TMD using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)
Summary
Temporomandibular disorders (TMD) are a broad category of conditions arising from the various com‐ ponents of the temporomandibular joint complex. Involvement of adjacent structures, such as referred pain to the ear, head area, and cervical involvement, add to the complexity of TMD and further contributes to disability in a subset of TMD patients [4] They bring limitations to mandibular movements, causing distress in performing daily activities [5]. Occlusion is one of the controversial factors studied for TMD It is not considered as the primary cause and its contribution might be limited to predisposing or perpetuating the existing condition [6, 7]. The concept of CSS revolves around the phenomena of central sensitization (CS), where neurons in the higher centres undergo morphological changes leading to alterations in their functionality These hyper excitable groups of neurons primarily work on amplifying the pain response by various means and affecting the pain behaviour [14]. In the process of chronification, other components such as an autonomic nervous system, endocrine, descending pathways and cognition adds to the complexity in the pathogenesis of TMD [14]
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