Revisiting the Risk Factors for Multiple Symptoms of Temporomandibular Disorders: A structured Cross-sectional Study

The Open Dentistry Journal 23 Oct 2020 RESEARCH ARTICLE DOI: 10.2174/1874210602014010503



The risk factors for Temporomandibular Disorders (TMD) are extensively studied, but the results showed no consistency. Only a small proportion of patients with TMD are likely to seek help and require treatment. Those individuals tend to present with multiple symptoms. This cohort of patients was not well investigated.


The study aimed to examine the association between possible risk factors for presentation with multiple TMD symptoms.


A population-based, cross-sectional study was conducted across 2101 individuals with an age range of 19-60 years. The condition was assessed via a detailed questionnaire comprising symptoms, habits, dental history, general health, sleep patterns, along with the completion of the Hospital Anxiety and Depression (HAD) scale, followed by an examination of the hypothesized clinical signs. The obtained data were tabulated and characterized the study population in a descriptive analysis in forms of percentages and frequencies. The significance level was set at P-value less than or equal to 0.005. The chi-squared test was implemented to assess the relationship between the multiple TMD symptoms reported and the potential risk factors.


Most participants reported a variable amount of stress. Moreover, 1528 (72.7 percent) mentioned abnormalities in sleep. About 80 percent had at least one TMD-related symptom. The multiple symptoms of TMD were identified among the 741 individuals. The following risk factors demonstrated association with a robust statistical significance (P=0.00), 1) occupation, 2) sleeping problems, 3) health concerns, 4) traumatic dental treatment, 5) various somatic symptoms, and 6) elevated HAD scale. When the outcomes of the clinical examination were analyzed, the statistical assessment could link soft tissue changes, namely; the cheek ridging and tongue indentations (P 0.00), with multiple symptoms of the condition.


Multiple TMD symptoms were prevalent among individuals with elevated stress, abnormal sleep pattern, traumatic dental treatment, elevated HAD scale. The results highlighted the importance of psychological factors in the pathogenesis of TMD.

Keywords: Temporomandibular disorders, Temporomandibular joint, Risk factors, Etiology, Orofacial pain, Hospital anxiety & depression.
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