Temporomandibular Disorders are Associated with Sociodemographic Factors, Health-Related and Oral Conditions in Adolescents: A Cross-Sectional Study

Ana Luiza Peres  Baldiotti; Gabrielle  Amaral-Freitas; Rafaela Scariot; Maria Luísa Leandro de Souza  Dias; Renata de Castro  Martins; Saul Martins  Paiva; Fernanda Morais  Ferreira

Authors

Ana Luiza Peres Baldiotti
Gabrielle Amaral-Freitas
Rafaela Scariot
Maria Luísa Leandro de Souza Dias
Renata de Castro Martins
Saul Martins Paiva
Fernanda Morais Ferreira

Keywords:

Temporomandibular Joint Disorders, Prevalence, Depression, Adolescent

Abstract

Objective: To assess the association between temporomandibular disorder (TMD) with sociodemographic factors, health-related factors, and oral conditions in adolescents. Material and Methods: This cross-sectional study was developed with 89 adolescents between 13 to 18 years. TMD diagnosis was obtained by the Research Diagnostic Criteria for Temporomandibular Disease (RDC/TMD) Axis I. Diagnoses of chronic pain, depression, presence of non-specific physical symptoms, including pain and anxiety, were obtained by the RDC/TMD Axis II. The feeling of happiness was measured by the Subjective Happiness Scale. Socio-economic and demographic characteristics were collected through self-administered questionnaires. Patients were examined for dental caries, dental trauma, malocclusion, and tooth wear. Parents answered a sociodemographic, economic, and general health questionnaire. Data were submitted to descriptive statistics, and a logistic regression model was used to assess the association between TMD and the socio-economic, demographic, health-related, and clinical variables. Results: TMD prevalence was 42%. TMD was associated to skin color (p=0.040), use of medications in the past year (p = 0.020) and previous dental trauma (p=0.030). Also, it tended to be associated with the presence of probable awake bruxism (p=0.053). Conclusion: Sociodemographic factors, health-related factors, and oral conditions play a role in TMD, with nonwhite adolescents, those who had used medications in the past year and/or had previous dental trauma having a greater chance of present this disorder.

References

Bertoli FMP, Bruzamolin CD, Pizzatto E, Losso EM, Brancher JA, de Souza JF. Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents. PLoS One 2018; 13(2):e0192254. https://doi.org/10.1371/journal.pone.0192254

Simoen L, Van den Berghe L, Jacquet W, Marks L. Depression and anxiety levels in patients with temporomandibular disorders: comparison with the general population. Clinical Oral Investig 2020; 24(11): 3939-45. https://doi.org/10.1007/s00784-020-03260-1

Fernandes G, Franco-Micheloni AL, Siqueira JT, Gonçalves DA, Camparis CM. Parafunctional habits are associated cumulatively to painful temporomandibular disorders in adolescents. Braz Oral Res 2016; 30(1). https://doi.org/10.1590/1807-3107BOR-2016.vol30.0015

Al-Khotani A, Naimi-Akbar A, Albadawi E, Ernberg M, Hedenberg-Magnusson B, Christidis N. Prevalence of diagnosed temporomandibular disorders among Saudi Arabian children and adolescents. J Headache Pain 2016; 17(1): 1-11. https://doi.org/10.1186/s10194-016-0642-9

Resende C, Rocha L, Paiva RP, Cavalcanti C, Almeida EO, Roncalli AG, Barbosa G. Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129(2):125-32. https://doi.org/10.1016/j.oooo.2019.10.007

Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita-Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey. BMC oral health 2015; 15(1):1-7. https://doi.org/10.1186/1472-6831-15-8

Bonjardim LR, Gavião MB, Pereira LJ, Castelo PM, Garcia RC. Signs and symptoms of temporomandibular disorders in adolescents. Braz Oral Res 2005; 19(2):93-8. https://doi.org/10.1590/s1806-83242005000200004

Melis M, Di Giosia M. The role of genetic factors in the etiology of temporomandibular disorders: a review. Cranio 2016; 34(1):43-51. https://doi.org/10.1179/2151090314Y.0000000027

Gillborg S, Åkerman S, Lundegren N, Ekberg EC. Temporomandibular disorder pain and related factors in an adult population: a cross-sectional study in southern Sweden. J Oral Facial Pain Headache 2017; 31(1):37-45. https://doi.org/10.11607/ofph.1517

Fernandes G, van Selms MK, Gonçalves DA, Lobbezoo F, Camparis CM. Factors associated with temporomandibular disorders pain in adolescents. J Oral Rehabil 2015; 42(2):113-9. https://doi.org/10.1111/joor.12238

Marangoni AF, de Godoy CH, Biasotto-Gonzalez DA, Alfaya TA, Fernandes KP, Mesquita-Ferrari RA, et al. Assessment of type of bite and vertical dimension of occlusion in children and adolescents with temporomandibular disorder. J Bodyw Mov Ther 2014; 18(3):435-40. https://doi.org/10.1016/j.jbmt.2013.10.001

Franco-Micheloni AL, Fernandes G, Gonçalves DA, Camparis CM. Temporomandibular disorders among Brazilian adolescents: reliability and validity of a screening questionnaire. J Appl Oral Sci 2014; 22(4):314-22. https://doi.org/10.1590/1678-77572013069

Organização Mundial de Saúde. Levantamentos Básicos em Saúde Bucal. 4 th. ed. São Paulo: Santos; 1999. 66p. [In Portuguese].

Cardoso CF, Drummond AF, Lages EM, Pretti H, Ferreira EF, Abreu MH. The Dental Aesthetic Index and dental health component of the Index of Orthodontic Treatment Need as tools in epidemiological studies. Int J Environ Res Public Health 2011; 8(8):3277-86. https://doi.org/10.3390/ijerph8083277

Costa RN, Abreu MH, Magalhães CS, Moreira NA. Validity of two occlusal indices for determining orthodontic treatment needs of patients treated in a public university in Belo Horizonte, Minas Gerais State, Brazil. Cad Saude Publica 2011; 27(3):581-90. https://doi.org/10.1590/s0102-311x2011000300018

Angle EH. Classification of malocclusion. Dent Cosmos 1899; 41:350-375.

Andreasen JO, Andreasen FM, Bakland LK, Flores MT. Traumatic Dental Injuries: A Manual. 2nd ed. Oxford: Blackwell; 2004.

Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 2018; 45(11):837-44. https://doi.org/10.1111/joor.12663

de Lucena LB, Kosminsky M, da Costa LJ, de Góes PS. Validation of the Portuguese version of the RDC/TMD Axis II questionnaire. Braz Oral Res 2006 20(4):312-17. https://doi.org/10.1590/s1806-83242006000400006

Barbosa ACDS, Pinho RCM, Vasconcelos MMVB, Magalhães BG, Dos Santos MTBR, de França Caldas Júnior A. Association between symptoms of depression and oral health conditions. Spec Care Dentist 2018; 38(2):65-72. https://doi.org/10.1111/scd.12278

de Medeiros ED, Nascimento AM, Mariano TE, Sales HFS, Medeiros PCB. Happiness Scale from Lima: factorial validity and internal consistency. Psicol Pesqui 2014; 8:150-8. https://doi.org/10.5327/Z1982-1247201400020004

Strizzi J, Fernández-Agis I, Parrón-Carreño T, Alarcón-Rodríguez R. Enacted Sexual Stigma, Stigma Consciousness, and Subjective Happiness Scale Adaptation: A Two-Country Study. J Interpers Violence 2016; 31(2):316-38. https://doi.org/10.1177/0886260514555372

Pais-Ribeiro JL. Validação transcultural da escala de felicidade subjectiva de Lyubomirsky e Lepper. Psicologia, Saúde e Doenças 2012; 13(2):157-68. [In Portuguese].

Sena MF, Mesquita KS, Santos FR, Silva FW, Serrano KV. Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr 2013; 31(4):538-45. https://doi.org/10.1590/S0103-05822013000400018

De La Torre Canales G, Câmara-Souza MB, Muñoz Lora V, Guarda-Nardini L, Conti P, Rodrigues Garcia RM, et al. Prevalence of psychosocial impairment in temporomandibular disorder patients: A systematic review. J Oral Rehabil 2018; 45(11):881-9. https://doi.org/10.1111/joor.12685

de Melo Júnior PC, Aroucha J, Arnaud M, Lima M, Gomes S, Ximenes R, et al. Prevalence of TMD and level of chronic pain in a group of Brazilian adolescents. PloS one 2019; 14(2):e0205874. https://doi.org/10.1371/journal.pone.0205874

Dean D. The first medications in my TMD toolbox. Cranio 2020; 38(1):1-4. https://doi.org/10.1080/08869634.2020.1691707

Li Y, Fang M, Niu L, Fan Y, Liu Y, Long Y, et al. Associations among gastroesophageal reflux disease, mental disorders, sleep and chronic temporomandibular disorder: a case-control study. CMAJ 2019; 191(33):E909–E915. https://doi.org/10.1503/cmaj.181535

Khan K, Muller-Bolla M, Anacleto Teixeira Junior O, Gornitsky M, Guimarães AS, Velly AM. Comorbid conditions associated with painful temporomandibular disorders in adolescents from Brazil, Canada and France: A cross-sectional study. J Oral Rehabil 2020; 47(4):417-24. https://doi.org/10.1111/joor.12923

Edwards CL, Fillingim RB, Keefe F. Race, ethnicity and pain. Pain 2001; 94(2):133-7. https://doi.org/10.1016/s0304-3959(01)00408-0

Magalhães BG, de-Sousa ST, de Mello VV, da-Silva-Barbosa AC, de-Assis-Morais MP, Barbosa-Vasconcelos MM, et al. Risk factors for temporomandibular disorder: binary logistic regression analysis. Med Oral patol Oral Cir Bucal 2014; 19(3):e232–e236. https://doi.org/10.4317/medoral.19434

Waisel DB. Vulnerable populations in healthcare. Curr Opin Anaesthesiol 2013; 26(2):186-92. https://doi.org/10.1097/ACO.0b013e32835e8c17

Widmalm SE, Christiansen RL, Gunn SM, Hawley LM. Prevalence of signs and symptoms of craniomandibular disorders and orofacial parafunction in 4-6-year-old African-American and Caucasian children. J Oral Rehabil 1995; 22(2):87-93. https://doi.org/10.1111/j.1365-2842.1995.tb00240.x

Robinson JL, Johnson PM, Kister K, Yin MT, Chen J, Wadhwa S. Estrogen signaling impacts temporomandibular joint and periodontal disease pathology. Odontology 2020; 108(2):153-65. https://doi.org/10.1007/s10266-019-00439-1

Kim HI, Lee JY, Kim YK, Kho HS. Clinical and psychological characteristics of TMD patients with trauma history. Oral Dis 2010; 16(2):188-92. https://doi.org/10.1111/j.1601-0825.2009.01626.x

Sharma S, Wactawski-Wende J, LaMonte MJ, Zhao J, Slade GD, Bair E, et al. Incident injury is strongly associated with subsequent incident temporomandibular disorder: results from the OPPERA study. Pain 2019; 160(7):1551-61. https://doi.org/10.1097/j.pain.0000000000001554

Reissmann DR, John MT, Aigner A, Schön G, Sierwald I, Schiffman EL. Interaction between awake and sleep bruxism is associated with increased presence of painful temporomandibular disorder. J Oral Facial Pain Headache 2017; 31(4):299-305. https://doi.org/10.11607/ofph.1885

de Paiva Bertoli FM, Bruzamolin CD, de Almeida Kranz GO, Losso EM, Brancher JA, de Souza JF. Anxiety and malocclusion are associated with temporomandibular disorders in adolescents diagnosed by RDC/TMD. A cross-sectional study. J Oral Rehabil 2018; 45(10):747-55. https://doi.org/10.1111/joor.12684

Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era?. J Oral Rehabil 2017; 44(11):908-23. https://doi.org/10.1111/joor.12531

Aboalnaga AA, Amer NM, Elnahas MO, Salah Fayed MM, Soliman SA, ElDakroury AE, et al. Malocclusion and temporomandibular disorders: verification of the controversy. J Oral facial Pain Headache 2019; 33(4):440-50. https://doi.org/10.11607/ofph.2260