There is limited understanding of how temporomandibular disorder (TMD) symptoms, psychological distress, and well-being are related to each other and to OHRQoL in Chinese young adults. This study aimed to identify correlations between TMD symptom severity, psychological status, and OHRQoL while also examining factors associated with low OHRQoL. Participants, recruited from a major university in the capital city, completed a survey that included demographics, the Chinese versions of the expanded five TMD symptoms (5Ts) screener, Depression, Anxiety, Stress Scales-21 (DASS-21), Ryff's Scales of Psychological Well-being-18 (SPWB-18), and Oral Health Impact Profile for TMDs (OHIP-TMD). Data were analysed using Chi-square and Kruskal-Wallis/Mann-Whitney U tests, Spearman's correlation, and logistic regression (α = 0.05). The study sample consisted of 414 individuals (mean age 22.0 years [SD 2.1], 77.8% female). Among them, 23.4%, 22.2%, 15.7%, and 38.6% had no (NT), intra-articular (IT), pain-related (PT), and combined (CT) TMD symptoms, respectively. Significant differences were observed in global TMD severity (CT>IT, PT>NT), global distress (CT>IT, NT), and OHRQoL (CT>IT, PT, NT), but not global well-being. Global TMD severity was significantly, albeit weakly, correlated with global distress (rs = 0.32) and global well-being (rs = -0.12). Global distress, in turn, showed a significant but weak negative association with global well-being (rs = -0.34). Both global TMD severity and global distress exhibited moderate correlations with global OHIP (rs = 0.63/0.42). Global TMD severity, incorporating symptom duration, frequency, intensity, and interference, was the main determinant of low OHRQoL in Chinese young adults.
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