Influence of temporomandibular disorder presence and severity on oral health-related quality of life

Abstract

BACKGROUND AND OBJECTIVES: Temporomandibular disorders are highly prevalent and may impair several oral function-related aspects. This study aimed at evaluating the impact of the presence and severity of temporomandibular disorder signs and symptoms on oral health-related quality of life. METHODS:Participated in the study 135 dentistry students of the Federal University of Paraiba. The presence of temporomandibular disorder was determined by means of an anamnesis questionnaire and a summarized clinical evaluation protocol. Oral health-related quality of life was determined by the summarized Oral Health Impact Profile version translated and validated for the Portuguese language. Statistical comparisons between Oral Health Impact Profile-14 means related to the presence of temporomandibular disorder signs and symptoms were achieved with Mann-Whitney and Kruskal-Wallis tests. RESULTS: Volunteers with temporomandibular disorder (p<0.001), needing treatment (p<0.001) and higher severity (p<0.001) had higher impact on oral health-related quality of life. Volunteers with clinical temporomandibular disorder signs had further quality of life impairment, being that individuals with simultaneous muscle and joint temporomandibular disorders (p=0.034) had higher Oral Health Impact Profile-14 scores. Most impaired domains were physical pain (p=0.045), functional limitation (p=0.007) and psychological discomfort (p=0.045). Influence of temporomandibular disorder presence and severity on oral health-related quality of life* Influência da presença e gravidade da disfunção temporomandibular na qualidade de vida relacionada com a saúde oral

Prevalência de sinais e sintomas de disfunção temporomandibular em estudantes pré-vestibulandos: associação de fatores emocionais, hábitos parafuncionais e impacto na qualidade de vida

“…A total of seven sites were analyzed by palpation on each side (three temporal, three masseter, and one lateral pterygoid), resulting in 14 muscular palpation sites per volunteer. Pain was quantified using objective values in which "0" indicated no pain, "1" tenderness was reported by the volunteer, "2" tenderness with physical manifestations, and "3" tenderness with evasion by the volunteer 23,35 . Joint sensitivity: Lateral palpation of the TMJ was performed with the volunteer at rest, and posterior palpation of the TMJ was palpated with maximum opening.…”

“…Both were conducted with a pressure of approximately 0.5 kg/cm 2 23,35 . Pain was quantified using objective values, as described above 23,35 . Joint Noise: The volunteers were asked to open and close their mouths three times.…”

“…The examiner's index fingers were positioned over the TMJs, allowing the evaluation of presence/ absence of clicking or crepitus (grinding sound during mandibular movement) to be detected. The presence of TMJ noise was considered when they were reproducible in at least two of three movements 23,35 . Active mouth opening: With the patient in maximum opening, the distance between the edges of the upper and lower middle incisors was measured, in millimeters (mm), using a caliper (NSK, Nippon Sokutei, Japan).…”

“…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] . Recent studies have also shown that the symptoms of TMD, especially pain, can increase the level of physical and mental harm, with negative effects on quality of life (QL) [19][20][21][22][23] . In addition, the literature has shown that the severity of TMD is reflected in the decrease in oral health-related quality of life (OHRQL) 23 .…”

“…In addition, the college entrance exam, which is considered to be a competitive and stressful system for acceptance to Brazilian universities, may be reflected by increased social and familial pressure, anxiety, stress, and other emotional disorders closely related to a diagnosis of TMD 25,26 . In addition, several studies have investigated the prevalence of TMD and associated factors in children 3,7,14,27 , adolescents 2,4,16 , college students 9,15,18,23,28 , adults 10,12,21,29 and elderly 30 , however few information is available about college preparatory students, subjected to high psychosocial burden, including psychological and physical manifestations of stress and anxiety 24,26,31,32 . Thus, the aim of this study is to evaluate the presence of signs and symptoms of TMD, its correlation with gender, reports of parafunctional habits, emotional stress, anxiety, and depression and its effects on OHRQL in college preparatory students enrolled in their last year of high school or college entrance exam courses in João Pessoa, Paraíba (PB).…”