Prevalence of temporomandibular disorder signs in patients with schizophrenia

Abstract

The aim of this study was to determine the prevalence of temporomandibular disorder (TMD) signs in a group of institutionalized patients with schizophrenia. Three hundred thirty-nine patients with schizophrenia were examined and compared with 107 age-matched and gender-matched control subjects. TMD signs were evaluated according to the Research Diagnostic Criteria to assess temporomandibular joint pain to palpation, limitation of maximum mouth opening, alteration of mouth opening pathway (deviation/deflection) and temporomandibular joint noises. In addition, tooth wear was recorded for the assessment of bruxism. The prevalence of any TMD signs was observed higher (P = 0.001) in the patients with schizophrenia (284/339, 83.7%) than in the controls (72/107, 67.3%). The prevalence of more than one TMD sign was also significantly higher (P = 0.03) in the patients with schizophrenia (131/339, 38.6%) than in the controls (29/107, 27.1%). Significant differences between the two groups were apparent for joint pain on palpation (P = 0.006), deflection (P = 0.006) and joint sounds (P = 0.002). Severe tooth wear was evident in 39.2% of the patients with schizophrenia compared with 21.2% in the control group (P = 0.001). The finding of the present study showed that, compared to control population, chronically hospitalized patients with schizophrenia seem to be more prone to the development of TMD signs and severe tooth wear and bruxism.

Signs of bruxism and temporomandibular disorders among patients with bipolar disorder

“…The main finding of the present study was a higher prevalence of bruxism and TMD signs, expressed as joint clicking, joint tenderness to palpation and masseter muscle tenderness to palpation and limited mouth opening in patints with BD compared to a control group. The results are consistent with previous clinical studies of psychiatric patients [3][4][5][6][7][8] . On the other hand, the present study only analyses the signs of the TMD which is not synonymous with the TMD.…”

“…A multiplicity of factors may be considered in efforts to explain this relationship. Like other psychiatric problems, these may include not only inherent conditions such as the burden of recurrent mood episodes, impaired cognitive and social functioning and relatively poor quality of life associ ated with the illness itself but also the side effects of the psychotropic medications [3][4][5][6][7][8] . Future research is encouraged to validate these preliminary results and evaluate further the relationship between BD and TMD.…”

“…In addition, psychiatric disorders and TMDs seem to share some of the same comorbidities, such as reduced quality of life 3,9 . In addition to the single or combined effects of the psychotropic drugs, the detorioration of the stomatognathic apparatus among psychiatric patients may be precipitated by the impaired social and cognitive functioning resulting in a relative poor quality of life 6,8,10 . It has also been suggested that bruxism may be associated with emotional tension, psychosomatic disorders, hostility, aggressiveness, apprehension and a tendency to worrying, as well as with psychiatric disorders [11][12][13] .…”

“…The etiology of TMDs involves biomechanical, neuromuscular, biopsychosocial, and neurobiological factors 2 . From an etiological viewpoint, there are some suggestions that psychosocial factors deserve special attention 3 , due to the fact that TMDs are quite common in patients with psychiatric disorders [3][4][5][6][7][8] . In addition, psychiatric disorders and TMDs seem to share some of the same comorbidities, such as reduced quality of life 3,9 .…”

Temporomandibular disorders in patients with schizophrenia using antipsychotic agents: a discussion paper

“…It has a worldwide prevalence of approximately 1%, begins most commonly in individuals who are 15–35 years old, and affects men and women equally. Its management involves the use of antipsychotic drugs, somatic treatment, and psychosocial therapies 2–4…”