Relationship between Oral Parafunctional and Postural Habits and the Symptoms of Temporomandibular Disorders: A Survey-Based Cross-Sectional Cohort Study Using Propensity Score Matching Analysis

Abstract

Temporomandibular disorders (TMDs) are a multifactorial joint disease of the masticatory system. The possible etiological factors involved in the onset and progression of TMDs include oral parafunctional habits (OPFHs) and postural habits (PHs). However, little information is available on the association between OPFHs and PHs and a predisposition to TMDs. Thus, to investigate whether the presence of OPFH and PH predisposes individuals to TMDs, a survey-based cross-sectional cohort study of self-reported TMD was performed. A total of 2292 patients with TMD were recruited for the survey. Through one-to-one propensity score matching, 166 patients with and without sleep bruxism (SB) were selected. The SB group had a significantly higher risk of masticatory muscular pain or fatigue than the non-SB group (p = 0.018). Furthermore, the SB group without other OFPHs and PHs did not show a significantly higher risk of TMD symptoms than the non-SB group. Diurnal clenching and bad posture also affect the stomatognathic system, causing pain or fatigue; however, it did not result in TMDs in patients without any OPFHs and PHs. This implies that OPFHs and PHs may increase the risk of TMD symptoms in coexistence with other habits.

Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis

“…The stabilization splints may result in a neuromuscular balance, removing posterior interferences and supplying a stable occlusal relationship and centric relation. The relationship between craniometrical posture and TMDs has been studied; however, despite the huge number of studies, clinicians and academics remain unconvinced [ 24 ]. There is evidence from certain studies that people with TMDs have altered head and cervical spine posture, while no such link is found in other investigations.…”

Association Between Orofacial Pain and Anxiety: A Systematic Review

“… 1 , 18 , 29 Injury to the structures related to the orofacial region may cause disorders that inflict orofacial pain. 33 , 34 Anxiety has also been reported to elevate cytokines level, which would be related to pain by its ability to promote inflammatory response and leading to pain symptoms. 32 Several studies suggested that anxiety is thought to have a pain catastrophizing effect, where a study on chronic musculoskeletal pain revealed that higher anxiety level was associated to higher pain sensitivity.…”

Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population

“… 13 These behaviors have been implicated as potential risk factors for TMDs. 14 The temporomandibular region features neural and biomechanical connections that form a complex functional unit, with studies suggesting that neural pathways associated with PT can be influenced by posture. 15 Interestingly, PT appears to be associated with Parkinson’s disease, possibly due to the clenching or grinding of teeth caused by muscle rigidity, spasm and jaw tremors caused by uncoordinated muscle contractions.…”