Understanding temporomandibular disorders through prevalence and associated risk factors: An epidemiological and clinical analysis

Abstract

This study aimed to determine the prevalence and characteristics of orofacial pain (OFP) with a focus on temporomandibular disorders (TMD) like symptoms in the population attending Westmead Hospital Centre for Oral Health (WHCOH). The second aim was to determine the frequency of TMD diagnostic groups and possible associated risk factors in treatment-seeking patients. For the first aim: 400 questionnaires were completed which deveolped from the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). For the second aim: 44 TMD patients and 30 matching controls were assessed with the RDC/TMD, Symptoms Checklist-90-Revised, clinical occlusal analysis and lateral cephalometric radiographs. Of the 400 surveyed participants, 61.5% reported at least one symptom of OFP while the most common were toothache (31.3%), jaw joint pain (23%) and muscle tenderness (17%). 35% of the pain participants reported that social and functional activities were significantly affected which encouraged treatment seeking behavior. Significant association between reporting OFP and socioeconomic factors were found (female (p<0.03) , age group of 40-50 years old (p<0.002), less than school education (p<0.002)). Clinically, the most frequent condition diagnosed with RDC/TMD in the 44 cases was right joint arthralgia (59%) and myofascial pain without limited opening (50%). Radiographically, TMD patients had longer anterior face heights (p=0.036) compared with controls. There was no significant difference between the skeletal classes across the RDC/TMD diagnostic groups. TMD cases showed significantly elevated psychological parameters (p≤0.001), number of mediotrusive contact (p=0.024) and bruxofacets (p=0.001) compared to controls. Prevalence of OFP was found higher than expected while TMD-like symptoms showed similar prevalence to the reported in Western countries. Association between OFP and socioeconomic factors were found. These findings can serve as base line information in the Australian population attending major dental hospital. Further population level surveys on the prevalence of TMD-like symptoms are still needed. Clinically, some risk factors were identified, however, there is still a need for larger longitudinal studies to confirm the results.