Prevalence of signs and symptoms of temporomandibular disorders in college preparatory students: associations with emotional factors, parafunctional habits, and impact on quality of life.

Marcilia Ribeiro Paulino,George Azevedo Lemos,Vanderlucia Gomes Moreira,André Ulisses Dantas Batista,Paulo Rogério Ferreti Bonan,Pâmela Lopes Pedro Da Silva

doi:10.1590/1413-81232018231.18952015

Abstract

The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) signs and symptoms, its correlation with gender, parafunctional habits, emotional stress, anxiety, and depression and its impact on oral health-related quality of life (OHRQL) in college preparatory students at public and private institutions in João Pessoa, Paraíba (PB). The sample consisted of 303 students. Presence of TMD symptoms was determined by an anamnesis questionnaire containing questions related to the presence of parafunctional habits and emotional stress. A simplified clinical evaluation protocol was used. Anxiety and depression were determined with the Hospital Anxiety and Depression (HAD) scale and the OHRQL using the short version contained in the Oral Health Impact Profile (OHIP-14). The Chi-square, Fisher Exact, Mann Whitney, and Kruskal-Wallis tests were performed. Presence of signs and symptoms of TMD was statistically associated (p ≤ 0,05) with female gender, parafunctional habits, emotional stress, and anxiety, and represented greater impairment of the OHRQL. The physical pain domain was the most affected. The increased prevalence of signs and symptoms of TMD among college preparatory students indicates that there is a need for education and clarification among teachers and students to improve early diagnosis and to prevent the problem.

Highlights

Anxiety and depression were determined with the Hospital Anxiety and Depression (HAD) scale and the OHRQL using the short version contained in the Oral Health Impact Profile (OHIP-14)
In concordance with the requirements and criteria established by Resolution num 196/96 of the National Health Council (NHC), the project was presented to the Research Ethics Committee (REC) of the Lauro Wanderley University Hospital at the Federal University of Paraíba (UFPB)
Based on the DMF index, some level of temporomandibular disorders (TMD) was identified in 89.8% of the participants, of which 50.2% had mild TMD, 33.0% moderate and only 6.6% severe. 39.6% of volunteers exhibited an active need for treatment

Summary

Introduction

The American Academy of Orofacial Pain (AAOP) defines temporomandibular disorder (TMD) as a group of painful and/or dysfunctional conditions related to the muscles of mastication, temporomandibular joints (TMJs), and related structures[1].The major signs and symptoms related to these disorders are pain in the TMJ region and palpation of the muscles of mastication, ear pain and other otologic signs, joint noise, mandibular misalignment, limited mouth opening, tiredness and muscular fatigue, headaches, and dental wear[2,3,4,5,6].TMD has a multifactorial etiology, including genetic and behavioral factors, direct and indirect trauma, psychological factors, and postural and parafunctional habits[2,7,8,9]. The American Academy of Orofacial Pain (AAOP) defines temporomandibular disorder (TMD) as a group of painful and/or dysfunctional conditions related to the muscles of mastication, temporomandibular joints (TMJs), and related structures[1]. Emotional distress, stress, anxiety, and depression have been linked to the presence of the signs and symptoms of this disorder in several populations[9,11,13,14,15]. These factors, especially stress and anxiety, may cause muscular hyperactivity and the development of parafunctional habits, leading to microtraumas of the TMJ and muscular lesions[16,17,18]

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