Oral health status in war veterans with post‐traumatic stress disorder

Abstract

The aim of this study was to assess the oral health condition of Croatian war veterans with post-traumatic stress disorder (PTSD). The study included 50 men who experienced combat stress and had been diagnosed with PTSD. They were compared with the group of 50 age-matched men who did not participate in war and did not have PTSD. Xerostomia, oral mucosal lesion, oral hygiene status, dental, and periodontal conditions, as well as temporomandibular disorders (TMDs) were assessed and compared between the groups. Subjects in PTSD group had poorer oral hygiene, and periodontal status compared with the control subjects. Furthermore, they had less teeth than the control group (P = 0.04). Although, there was no statistically significant difference between the groups in Decayed, Missing and Filled Teeth (DMFT) index (P = 0.36), PTSD group had more decayed and missing teeth, but less filled teeth (P < 0.05 for all). According the Research Diagnosis Criteria for Temporomandibular Disorder (RDC/TMD), PTSD patients had more TMD diagnoses compared with the control subjects. The most prevalent diagnosis was myofascial pain (48%) in PTSD group, while in the control group it was disc displacement with reduction (8%). It can be concluded that the oral health condition in PTSD patients is significantly affected compared with the control subjects.

Post-traumatic stress disorder and temporomandibular dysfunction: a review and clinical implications

“…Muhvić-Urek et al 8 Case-control 50 war veterans with PTSD 50 healthy subjects 100% men TMD prevalence was 48% in the veterans and 8% in the control group. The most common diagnosis was myofascial pain among veterans and disc displacement in the control group.…”

“…After sorting the titles and abstracts, 12 articles were selected for a complete reading of the texts. From these, six meet the inclusion criteria [6][7][8][17][18][19] . One paper was excluded because it did not evaluate the relationship between TMD and PTSD 20 and five because they did not use diagnostic criteria validated for TMD, only evaluating signs and symptoms of dysfunction in the studied population [21][22][23][24][25] .…”

“…In these papers 6,7,17,18 the participants were not formally diagnosed (medical diagnosis) with PTSD but had symptoms consistent with PTSD diagnosis identified by Post-Traumatic Stress Disorder Check List-Civilian (PCL-C) 26 , a structured questionnaire, developed according to the DSM, and validated to investigate the PTSD prevalence in epidemiological surveys. Only one paper investigated the TMD prevalence in PTSD subjects 8 . TMD prevalence was 48% in PTSD subjects and 8% in healthy subjects.…”

“…Evidence shows that chronic painful TMD pictures often coexist with PTSD. Epidemiological studies have indicated that PTSD is more prevalent in TMD patients when compared to the general population 6,7 and PTSD subjects also presented more TMD than subjects without the disorder 8 . In addition, the comorbidity relationship between TMD and PTSD may be a complicating factor for TMD handling, as it reduces the efficacy of commonly used therapeutic interventions 9 .…”

Links between oral health and personality at a law enforcement school

“…Suman et al (2008) investigated the effect of the war on oral health among professional soldiers and found the number of decayed, filled and missing teeth was significantly higher (DMFT 14.4) among those who had been in combat than among those who had not (DMFT 13.1) [14]. Muhvic-Urek et al (2007) studied dental status of war veterans of the Croatian army suffering from post-traumatic stress disorder and found that they had higher DMFT values than the control group, although the difference was not statistically significant [23]. Vered and Sgan-Cohen (2003) carried out a questionnaire survey on 4920, 21-year-old young Israeli people on compulsory military service, asking them how they assessed the status of their own teeth.…”