Conceptualising TMD symptom burden in youths: Symptom duration, frequency, intensity and interference.

OBJECTIVE: This study aimed to conceptualise Temporomandibular disorder (TMD) symptom burden and severity and explored their interrelationships with somatic symptoms and psychological distress. METHODS: Participants were recruited from a local polytechnic. The quintessential five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) were appraised and extended to evaluate the duration, frequency, intensity and interference of discrete TMD symptoms. Global TMD severity (GS) was computed by totaling the points for all TMD symptoms and dimensions. TMD (TS) and somatic symptom (SS) burden were assessed based on the Somatic Symptoms Scale-8, while psychological distress was measured with the Depression, Anxiety and Stress Scales-21. Statistical analyses were performed using Kruskal-Wallis/Dunn tests and Spearman's correlation (α = .05). RESULT: Of the 366 eligible participants (mean age 19.1 ± 2.3 years), 51.4% were 5Ts-negative and 48.6% were 5Ts-positive. Among the 5Ts-positive individuals, 25.3%/64.0% were 'bothered a little' whereas 4.5%/10.7% were 'bothered a lot' by TMD pain/headache. Correspondingly, 32.6%/12.4%/5.1% were 'bothered a little' while 2.8%/2.8%/1.1% were 'bothered a lot' by TMJ sounds/closed/open locking. TS burden was moderate-to-strongly correlated to aggregate symptom duration, frequency, intensity, interference, GS and SS burden (rs = .50-.88). While TS burden and GS were weakly associated with psychological distress (rs = .18-.36), SS burden was moderately related to depression, anxiety and stress (rs = .47-.53). CONCLUSIONS: TS burden can serve as a proxy for global TMD severity and may be more meaningful than the mere presence of TMD symptoms in clinical and research settings.

Comorbidities between temporomandibular disorders and somatization in young adults: exploring links with personality, emotional, and sleep disturbances.

OBJECTIVE: The comorbidities between temporomandibular disorders (TMDs) and somatization and their associations with personality traits, emotional disorders, and sleep disturbances were investigated. STUDY DESIGN: Adults aged 18 to 24 years completed an electronic survey encompassing TMD symptoms (5Ts), Patient Health Questionnaire-15, Big Five Personality Inventory-10, Depression Anxiety Stress Scales-21, and Pittsburgh Sleep Quality Index. Data were assessed using non-parametric tests/correlation analysis and logistic regression analysis (α = 0.05). RESULTS: The sample comprised 365 participants, of whom 22.2% and 19.5% were 5Ts-negative without and with somatization, respectively, and 18.1% and 40.3% were 5Ts-positive without and with somatization, respectively. Significant differences in neuroticism, distress, depression, anxiety, stress, and sleep quality were observed between 5Ts-negative participants with somatization and 5Ts-positive participants with somatization compared with 5Ts-negative participants without somatization and 5Ts-positive participants without somatization. Distress, anxiety, stress, and sleep were moderately correlated with somatic but not TMD symptoms (rs = 0.45-0.52). CONCLUSIONS: Irrespective of whether they had TMDs, participants with somatization exhibited heightened levels of neuroticism and emotional and sleep disturbances.

Temporomandibular disorder pain in older adolescents-young adults: Interrelationship with somatic burden, mental ill-being, and well-being.

OBJECTIVES: The associations of Temporomandibular disorder (TMD) pain with somatic symptoms, mental ill-being/distress, and well-being were explored, along with the mental correlates of TMD (TS) and somatic symptom (SS) burden in older adolescents-young adults. METHODS: TMD/somatic symptoms were appraised with the five quintessential symptoms (5Ts) of the DC/TMD/Somatic Symptom Scale-8, whereas mental distress/well-being was assessed with the Depression, Anxiety, Stress Scales-21/Scales of Psychological Well-being-18. Data were examined using Chi-square/non-parametric tests and multivariate analyses (α = .05). RESULTS: Among the 366 participants, 51.4%, 28.1%, 6.8%, and 13.7% had no TMD (NT), TMD pain (TP), TMD dysfunction (TD), and combined TMD (CT) respectively. Though mental distress varied substantially (CT, TP>NT, TD), no significant differences in well-being were discerned. SS burden, but not TS burden, was moderately correlated to distress. CONCLUSIONS: The prospect of TMD pain was increased by being female, depressed, and anxious but reduced by "positive relations with others" and "self-acceptance".

Age distribution of East Asian TMD patients and age-related differences in DC/TMD axis I findings.

OBJECTIVES: The pattern of age distribution in East Asian temporomandibular disorder (TMD) patients and age-related differences in DC/TMD diagnostic subtypes/categories were evaluated. SUBJECTS AND METHODS: TMD patients from two University-based centers in China and South Korea were enrolled. Axis I physical diagnoses were rendered according to DC/TMD. Patients were categorized into six age groups (15-24, 25-34, 35-44, 45-54, 55-64, and 65-84 years; Groups A-F respectively). RESULTS: Youths/young adults (Groups A-C) formed 74.1% of TMD patients. TMJ disc displacements (74.9%), arthralgia (49.2%), and degenerative joint disease [DJD] (36.8%) were the most common TMD subtypes. The majority had combined (54.0%) and chronic (58.5%) TMDs. Youths/young adults and middle-aged/old adults had substantially lower frequencies of merely pain-related (6.2-14.5%) and intra-articular (13.8-16.8%) TMDs correspondingly. "Being female" increased the prospects of pain-related/combined TMDs by 96%/49%, respectively. CONCLUSIONS: East Asian TMD patients comprised mostly of youths/young adults who had an alarmingly high prevalence of TMJ DJD.

The oral and systemic health impact profile for periodontal disease (OSHIP-Perio)-Part 2: Responsiveness and minimal important difference.

OBJECTIVES: The Oral and Systemic Health Impact Profile for Periodontal Disease (OSHIP-Perio) was developed to measure health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL). This study aimed to determine the responsiveness and minimal importance difference (MID) of the OSHIP-Perio. METHODS: Subjects with periodontal disease completed the OSHIP-Perio at baseline and six to ten weeks after non-surgical periodontal therapy. Comparisons of the clinical variables and the OSHIP-Perio scores before and after treatment were analysed using the Wilcoxon signed-rank test, together with the Oral Health Impact Profile (OHIP-49, OHIP-14 and OHIP-5) scores. The MIDs for all the instruments were calculated using distribution-based methods. RESULTS: Fifty-one case subjects who completed periodontal treatment and the OSHIP-Perio instrument were included for analysis. Significant improvement in all clinical variables after treatment (p < 0.001) was observed. The OSHIP-Perio total score as well as its four-dimensional scores (periodontal, oral function, orofacial pain and psychosocial impact) were significantly reduced after treatment (p < 0.001), indicating better OHRQoL. Findings were consistent with the other OHIP instruments. In determining the MID, the percentage point change of the OSHIP-Perio was found to be lower than the shorter OHIP-5 instrument when using both effect sizes (ES) (10.71% vs. 15.0% at 0.5SD) and standard error of measurement (SEM) (5.36% vs. 10.0% at 1SEM; 8.93% vs. 20.0% at 2SEM) calculations. CONCLUSIONS: The OSHIP-Perio demonstrated good responsiveness which was comparable to the OHIP-49 and its short-form derivatives. Its required percentage point change in determining its MID is smaller than the OHIP-5.

The oral and systemic health impact profile for periodontal disease (OSHIP-Perio)-Part 1: development and validation.

OBJECTIVES: This study aimed to develop and validate the Oral and Systemic Health Impact Profile for Periodontal Disease (OSHIP-Perio), a disease-specific instrument for assessing the impact of periodontal disease on both general and oral health-related quality of life. METHODS: A pool of 58 items, developed from the Oral Health Impact Profile (OHIP-49) and data generated through semi-structured patient interviews, was tested on 80 case subjects with periodontal disease and 80 control subjects. The dimensionality of the preliminary measure was evaluated using exploratory factor analysis (EFA). Rasch analysis was then performed on the primary dimension using the Winsteps software (Version 5.1.4.0) to render the final items for the OSHIP-Perio. The reliability and validity of the final OSHIP-Perio were subsequently determined. RESULTS: Using an EFA factor loading >0.50, the primary dimension comprised 18 items. Using Rasch analysis, four items were subsequently excluded. The final OSHIP-Perio with 14 items showed excellent test-retest reliability (overall intraclass correlation coefficient index = 0.99) and internal consistency (overall Cronbach's alpha coefficient = 0.96). It also exhibited good discriminant validity when case and control groups were compared (p < 0.001). It showed very strong correlations (rho coefficients >0.90) with the OHIP-5, OHIP-14 and OHIP-49, exhibiting good concurrent validity. It demonstrated a moderate correlation (rho coefficient = 0.60) with the global health rating, exhibiting a moderate convergent validity. CONCLUSIONS: The 14-item OSHIP-Perio exhibited good psychometric properties comparable to the OHIP-5, OHIP-14 and OHIP-49 for evaluating the impact of periodontal disease on quality of life.

Correlates of jaw functional limitation, somatization and psychological distress among different temporomandibular disorder diagnostic subtypes.

OBJECTIVES: This study investigated the jaw functional status and severity of somatic/psychological symptoms in different Diagnostic Criteria for temporomandibular disorders (DC/TMD) diagnostic subtypes and established the correlates between jaw functional limitation, somatization, depression and anxiety. METHODS: Data were accrued from consecutive 'first-visit' patients seeking TMD treatment at a university-based oral medicine/diagnosis clinic. Axis I physical TMD diagnoses were derived using the DC/TMD methodology and patients were categorized into pain-related (PT), intra-articular (IT) and combined (CT) TMD groups. Axis II measures were also administered and included the Jaw Functional Limitation Scale-20 (JFLS-20), Patient Health Questionnaire-15 and 9 (PHQ-15 and PHQ-9) and General Anxiety Disorder Scale-7 (GAD-7). Chi-square/Kruskal-Wallis tests and Spearman's correlation were employed for statistical evaluations (α = .05). RESULTS: The final dataset consisted of 772 TMD patients (mean age of 37.7 ± 15.9 years; 70.2% females). The prevalence of PT, IT and CT was 11.9%, 15.7% and 72.4%, respectively. Significant differences in functional jaw limitations, somatization, depression (CT, PT > IT) and anxiety (CT > PT, IT) were observed. Moderate-to-severe somatization, depression and anxiety were detected in 12.6%-15.7% of patients. For all three TMD groups, JFLS global scale/subscale scores were weakly associated with somatization, depression and anxiety scores (rs < 0.4). Moderate-to-strong correlations were noted between somatization, depression and anxiety (rs = 0.50-0.74). CONCLUSIONS: Functional jaw limitations were associated with painful TMDs but appear to be unrelated to somatization and psychological distress. Somatization and depression/anxiety were moderately correlated, underscoring the importance of somatic symptom screening when managing TMD patients.

DC/TMD axis I subtyping: generational and gender variations among East Asian TMD patients.

OBJECTIVES: This study examined the generational-gender distinctions in Diagnostic Criteria for Temporomandibular disorders (DC/TMD) subtypes among East Asian patients. METHODS: Consecutive "first-visit" TMD patients presenting at two university-based TMD/orofacial pain clinics in China and South Korea were enlisted. Demographic information along with symptom history was gathered and clinical examinations were performed according to the DC/TMD methodology. Axis I physical diagnoses were rendered with the DC/TMD algorithms and categorized into painful and non-painful TMDs. Patients were categorized into three birth cohorts, specifically Gen X, Y, and Z (born 1965-1980, 1981-1999, and 2000-2012 respectively) and the two genders. Data were evaluated using Chi-square/Kruskal-Wallis plus post-hoc tests and logistic regression analyses (α = 0.05). RESULTS: Gen X, Y, and Z formed 17.2%, 62.1%, and 20.7% of the 1717 eligible patients examined (mean age 29.7 ± 10.6 years; 75.7% women). Significant differences in prevalences of arthralgia, myalgia, headache (Gen X ≥ Y > Z), and disc displacements (Gen Z > Y > X) were observed among the three generations. Gen Z had substantially fewer pain-related and more intra-articular conditions than the other generations. Women presented a significantly greater frequency of degenerative joint disease and number of intra-articular conditions than men. After controlling for generation-gender interactions, multivariate analyses showed that "being Gen X" and female increased the risk of painful TMDs (OR = 2.20) and reduced the odds of non-painful TMDs (OR = 0.46). CONCLUSIONS: Generational-gender diversities in DC/TMD subtypes exist and are important for guiding TMD care and future research endeavors.

Psychological factors in Temporomandibular disorders and somatization: A multidimensional analysis of personality, coping, and distress among young adults.

PURPOSE: The association of Temporomandibular disorder (TMD) and somatic symptoms with the psychological variables of personality, coping, and distress were analyzed in young adults. Physical and psychological correlates were also explored along with the risk factors for TMDs/somatization. MATERIALS AND METHODS: Participants were enlisted from a local university and the presence of TMDs and somatic symptoms was determined with the Short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. The psychological variables of personality, coping, and distress was assessed with the Big-Five Personality Inventory-10, brief-COPE Inventory, and Depression, Anxiety, Stress Scales-21 accordingly. Statistical evaluations were performed with the Mann-Whitney U test, Spearman's correlation, and logistic regression analyses (α = 0.05). RESULTS: Among the 455 participants (mean age 22.7 ± 1.2 years), 18.2% and 5.7% had TMDs and medium-to-high somatization respectively. Participants with TMDs exhibited substantially higher somatization and psychological distress scores than those with no TMDs. Significant differences in TMD, conscientiousness, extraversion, and psychological distress scores were observed between participants with no-to-mild and medium-to-high somatization. The association between TMD and somatization scores, albeit significant, was weak. Neuroticism and dysfunctional coping style were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.62). CONCLUSIONS: Findings suggest that anxiety is the main risk factor for the presence of TMDs and medium-to-high somatization in non-clinical young adults while conscientiousness is a protective factor for somatization.

The Physical Symptom Scale-8: Psychometric Characteristics of a Short-Form Version of the PHQ-15 and its Use in TMD-Related Assessment and Research.

AIMS: To describe the development of the Physical Symptom Scale-8 (PSS-8) and to examine its psychometric properties and use in temporomandibular disorder (TMD)-related assessment and research. METHODS: An online survey comprising demographic variables, the DC/TMD pain screener (TPS), Short-Form Fonseca Anamnestic Index (SFAI), PSS-8, PHQ-15, and Depression, Anxiety, and Stress Scale-21 (DASS-21) was administered to young adults attending a technical college. The PSS-8 adopted the Somatic Symptom Scale-8 (SSS-8) items but maintained the 3-point response scale and 4-week time frame of the PHQ-15. Internal consistency and reliability of the PSS-8 were determined by its Cronbach α value. Known-groups and concurrent/convergent validity were examined using Mann-Whitney U test and Spearman correlation (α = .05), respectively. RESULTS: Responses from 400 participants (mean age 18.8 ± 1.5 years; 52.3% women) were evaluated. Pain-related (WPT) and all (WAT) TMDs were present in 8.5% and 17.3% of the sample, respectively. The PSS-8 exhibited good internal consistency (α = 0.82) and sound known-groups validity, with the WPT/WAT groups having significantly higher PSS-8 scores than those without TMDs. Good concurrent and convergent validity were also observed, with moderate to strong correlations with the PHQ-15 (rs = 0.97) and DASS-21 scores (rs = 0.48 to 0.60). Correlations with the TPS and SFAI scores were weaker (rs = 0.28 to 0.34). CONCLUSION: The PSS-8 presented good psychometric properties and performed similarly to the PHQ-15. It holds promise as the "de facto" shortened version of the PHQ-15 for TMDs and related work.

Psychological characteristics of young adults with temporomandibular disorders, somatization and combined conditions: A multidimensional evaluation.

BACKGROUND: Temporomandibular disorders and somatization have shown interrelation in many studies. The physical and psychological factors which contributed to the occurrence and relation of both conditions are yet to be determined. OBJECTIVES: The personality traits, coping styles and psychological distress of young adults with temporomandibular disorder (TMD) and somatic symptoms were characterized together with the determination of psychological risk factors for TMDs, somatization and combined conditions. METHODS: Participants were recruited from university-attending young adults. TMD and somatic symptoms were appraised with the short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. Psychological variables were assessed with the Big Five Personality Inventory-10, Brief-COPE Inventory and Depression, Anxiety, and Stress Scales-21. Data were evaluated using chi-squared/non-parametric tests and logistic regression analyses (α = .05). RESULTS: Among the 507 participants (mean age 22.2 ± 1.5 years), 46.4% reported no TMD/somatic symptoms (NS) while 7.5%, 34.5% and 11.6% had TMDs only (TS), somatization only (SS) and combined TMDs-somatization (CS), respectively. Significant differences in conscientiousness (NS > SS), agreeableness (NS, TS > CS; NS > SS), dysfunctional coping, general distress, depression, anxiety and stress (CS ≥ SS > NS) were discerned. Multivariate analyses indicated that the odds of TS were increased by anxiety (OR = 1.10; 95% CI = 1.01-1.21), while the odds of SS/CS were affected by anxiety (OR = 1.15; 95% CI = 1.06-1.25/OR = 1.34; 95% CI = 0.19-1.52) and problem-focused coping (OR = 0.71; 95% CI = 0.56-0.89/OR = 0.55; 95% CI = 0.39-0.78). CONCLUSION: Though individuals with TMDs and somatization have dissimilar psychological profiles, anxiety constantly increased their likelihood. Problem-focused coping strategies may help alleviate psychosocial and physical stressors associated with TMDs and somatization.

Oral behaviors in young adults: a multidimensional evaluation of the influence of personality, coping, and distress.

OBJECTIVES: This study explored the relationship of oral parafunction to the psychological variables of personality, coping, and distress. Correlates of sleeping/waking-state oral activities with the different psychological factors were also examined, along with psychological predictors for high parafunction. MATERIALS AND METHODS: Young adults from a large private university were enrolled. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC), and participants were stratified into low and high parafunction (LP/HP) groups following the DC/TMD. Personality traits, coping styles, and psychological distress were assessed with the Big Five Personality Inventory-10 (BFI-10), brief-COPE Inventory (BCI), and Depression, Anxiety, Stress Scales-21 (DASS-21) correspondingly. Statistical evaluations were performed using the chi-square/Mann-Whitney U tests, Spearman's correlation, and logistic regression analyses (α = 0.05). RESULTS: Among the 507 participants (mean age 22.2 ± 1.5 years), 84.6% and 15.4% had low and high parafunction respectively. While personality profiles did not vary substantially, the HP group exhibited significantly greater emotion-focused/dysfunctional coping, general distress, depression, anxiety, and stress scores than the LP group. Associations between OBC and the various psychological variables were weak when significant or insignificant. Neuroticism and dysfunctional coping were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.60/0.45-0.51). Multivariate analyses indicated that high parafunction was predicted by dysfunctional coping style (OR = 2.55) and anxiety (OR = 1.33). CONCLUSIONS: Dysfunctional coping was the main risk factor for high parafunction, increasing its odds by about 2.5 times. CLINICAL RELEVANCE: Oral parafunction appears to be a dysfunctional coping response to psychological distress.

Comparison of painful temporomandibular disorders, psychological characteristics, sleep quality, and oral health-related quality of life of patients seeking care before and during the Covid-19 pandemic.

BACKGROUND: Literature concerning Temporomandibular disorders (TMDs) and the Covid-19 pandemic is limited and disparate findings related to TMD frequencies, psychological distress, and quality of life were presented. This study investigated the prevalence of painful Temporomandibular disorders (TMDs) and compared the psychological, sleep, and oral health-related quality of life profiles of patients seeking TMD care before and during the Covid-19 pandemic. METHODS: Data were accrued from consecutive adult patients 12 months before (BC; control) and during (DC; case group) the Covid-19 pandemic. The Diagnostic Criteria for TMDs (DC/TMD), Depression, Anxiety, Stress Scales (DASS)-21, Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile (OHIP)-TMDs were utilized and statistical analysis was performed using Chi-square/non-parametric tests (α = 0.05). RESULTS: The prevalence of painful TMDs was 50.8% before and 46.3% during the pandemic. Significant differences in PSQI and OHIP component scores were discerned between the BC and DC groups contingent on TMD pain. Total-DASS was moderately correlated to total-PSQI/OHIP (rs = 0.41-0.63). CONCLUSION: The covid-19 pandemic did not appear to exacerbate psychological distress but affected sleep and increased unease over TMD dysfunction.

Noninvasive interventions for temporomandibular disorders: a scoping review of systematic reviews from 2017 to 2022.

OBJECTIVES: This scoping review assessed systematic reviews on noninvasive temporomandibular disorder therapies to identify evidence gaps and formulate clinical recommendations. METHOD AND MATERIALS: The scoping review was conducted according to the PRISMA scoping review guidelines and Joanna Briggs Institute updated scoping review methodology using a two-step process involving four reviewers. Four key databases (Embase, PubMed, Scopus, and Google Scholar) were thoroughly searched from January 2017 to December 2022. The selected systematic reviews were classified, charted, critically appraised, and synthesized. RESULTS: Of the initial 522 listings, 61 systematic reviews were eligible for inclusion, with the majority bearing very low- to low-quality evidence, and meta-analysis not being conducted in about a third of them. Moderate- to high-quality evidence was available for patient self-management, botulinum toxin, manual, laser, and splint therapy. CONCLUSIONS: Further high-quality investigations with consistent patient selection, diagnostic criteria, treatment/assessment protocols, and outcome measures are needed to confirm the effectiveness of the various interventions for temporomandibular disorder pain/dysfunction.

Sleep bruxism events: an epiphenomenon of severe obstructive sleep apnea?

OBJECTIVES: This study investigated the temporal relationships between apnea-hypopnea (AH) and sleep bruxism (SB) events and correlated SB to various respiratory/sleep indexes in adult patients with concomitant obstructive sleep apnea (OSA) and SB. MATERIALS AND METHODS: Nocturnal PSG data of 147 consecutive OSA patients were examined for comorbid SB. Among the 49 subjects with coexisting OSA and SB, 26 were randomly selected for in-depth appraisal of temporal patterns which were classified as T1 (unrelated activities), T2 (AH events occur before SB events), T3 (SB events occur before AH events), and T4 (AH and SB events occur simultaneously). Data were analyzed using Mann-Whitney U tests and Spearman's correlation (α = 0.05). RESULTS: The majority (84.5%) of AH events were unrelated to SB events. Of the 15.5% of related activities, T2 and T3 patterns occurred in 14.1% and 1.4%, respectively. SB events/index, the percentage of unrelated/related AH-SB events, and T2-T3 episodes were not associated with gender, age, body mass (BMI), and apnea-hypopnea (AHI) index. SB events were related to total sleep time (rs = 0.44), but no significant associations were discerned between SB and AH index. CONCLUSIONS: As most AH events were unrelated to SB events, OSA and SB are probably epiphenomena in adult patients with concomitant conditions. Where AH-SB events were related, the T2 temporal pattern, where SB events were subsequent to AH events, featured predominantly alluding to a specific form of secondary SB triggered by sleep micro-arousals. CLINICAL RELEVANCE: AH and SB events are probably epiphenomena in adult patients with coexisting OSA and SB. Even so, OSA patients should be routinely screened for SB and vice versa considering their frequent comorbidity.

DC/TMD Axis I diagnostic subtypes in TMD patients from Confucian heritage cultures: a stratified reporting framework.

OBJECTIVES: This study proposed a conceptual framework for reporting Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I conditions and investigated the prevalence of TMD subtypes/categories in patients from Confucian heritage cultures. Variances in gender, age, and TMD chronicity between Chinese (CN) and Korean (KR) patients were also explored. MATERIALS AND METHODS: Subjects were recruited from consecutive patients seeking care at two University-based centers in Beijing and Seoul. Eligible patients completed a demographic survey as well as the DC/TMD Symptom Questionnaire and were clinically examined according to the DC/TMD methodology. Axis I diagnoses were subsequently rendered with the DC/TMD algorithms and documented using the stratified reporting framework. Statistical evaluations were performed with chi-square, Mann-Whitney U tests, and logistic regression analysis (α = 0.05). RESULTS: Data of 2008 TMD patients (mean age 34.8 ± 16.2 years) were appraised. Substantial differences in female-to-male ratio (CN > KR), age (KR > CN), and TMD duration (KR > CN) were observed. Ranked frequencies of the most common Axis I diagnoses were: CN - disc displacements (69.7%) > arthralgia (39.9%) > degenerative joint disease (36.7%); KR - disc displacements (81.0%) > myalgia (60.2%) > arthralgia (56.1%). Concerning TMD categories, notable differences in the prevalence of intra-articular (CN 55.1% > KR 15.4%) and combined (KR 71.8% > CN 33.4%) TMDs were discerned. CONCLUSIONS: Though culturally similar, the two countries require disparate TMD care planning/prioritization. While TMJ disorders in children/adolescents and young adults should be emphasized in China, the focus in Korea would be on TMD pain in young and middle-aged adults. CLINICAL RELEVANCE: Besides culture, other variables including socioeconomic, environmental, and psychosocial factors can influence the clinical presentation of TMDs. Chinese and Korean TMD patients exhibited significantly more intra-articular and combined TMDs respectively.

Painful temporomandibular disorders in Confucian-heritage cultures: Their inter-relationship with bodily pain, psychological well-being and distress.

BACKGROUND: Temporomandibular disorders (TMDs) are common and affect individuals negatively. OBJECTIVES: This study investigated the inter-relationship of painful TMDs with bodily pain, psychological well-being and distress in young people from a Confucian-heritage culture (CHC). METHODS: Adolescents/young adults were recruited from a polytechnic in Singapore. While the presence/severity of painful TMDs and bodily pain were established with the DC/TMD Pain Screener (TPS) and Maciel's Pain Inventory, psychological well-being and distress were evaluated with the Scales of Psychological Well-being-18 (SPWB-18) and Patient Health Questionnaire-4 (PHQ-4). Statistical explorations were conducted using chi-square/Mann-Whitney U tests, Spearman's correlation and logistic regression analyses (α = .05). RESULTS: Among the 225 participants (mean age 20.1 ± 3.9 years) examined, 11.6% had painful TMDs and 68.9% experienced multisite bodily pain. Though painful TMDs were accompanied by a higher occurrence of multisite bodily pain, the overall/discrete number of bodily pain sites did not differ substantially between the 'no TMD pain' (NT) and 'with TMD pain' (WT) groups. Besides ear pain, differences in overall/discrete bodily pain scores were also insignificant. However, significant differences in environmental mastery, overall psychological distress, depression and anxiety subscale scores were discerned between the NT and WT groups. Psychological well-being and distress were moderately and negatively correlated (rs = -.56). Multivariate analysis indicated that ear pain and psychological distress increased the prospect of painful TMDs. CONCLUSION: The prevalence of multi-site bodily pain was high in young people from CHCs irrespective of the painful TMDs' presence of painful TMDs. Enhancing environmental mastery and relieving depression/anxiety may help manage TMD pain.

Temporomandibular disorder, otologic, body pain, and psychological symptoms: Their inter-relationships in Asian youths.

PURPOSE: This study aimed to establish the inter-relationships between Temporomandibular disorders (TMDs), otologic, pain, and psychological comorbidities in Asian youths. METHODS: Youths, aged 17 to 24 years old, were enrolled from a local polytechnic and an electronic survey encompassing demographic variables, the DC/TMD TMD pain screener (TPS), Short-form Fonseca Anamnestic Index (SFAI), modified Maciel's Otologic/Pain Symptom Inventory, and Patient Health Questionnaire-4 was administered. Participants were subsequently categorized into "no TMD pain (NP)" and "with TMD pain (WP)" in addition to "no TMDs (NT)" and "with any TMDs (WT)" groups. Data were evaluated with the Chi-square test, non-parametric, and logistic regression analyses (α = 0.05). RESULTS: Among the 198 participants (mean age 18.8 ± 1.7 years), 11.1% had painful TMDs and 18.2% experienced TMD pain and/or dysfunction. Significant differences in total-otologic symptom (total-OS), vertigo, and dizziness plus otalgia, tinnitus, and hearing loss scores were observed between the WP-NP and WT-NT groups correspondingly. While total-comorbid pain (total-CP) and psychological distress (total-PD) scores varied substantially between the WT-NT group, only a significant difference in total-PD scores was discerned between the WP-NP group. Total-OS scores were moderately correlated to TPS/SFAI, total-CP, total-PD scores. and psychological distress was a risk factor for painful TMDs. CONCLUSION: Otologic and pain comorbidities were prevalent among Asian youths with TMDs and appear to be interrelated. The complex interaction of TMDs with otological, pain, and psychological comorbidities must be considered when caring for youths with multiple somatic complaints. Int J Prosthodont 2023. doi: 10.11607/ijp.8451.

Personality, psychosocial and oral behavioural risk factors for temporomandibular disorder symptoms in Asian young adults.

BACKGROUND: The relation between personality, psychosocial factors, somatisation, andoral behaviours as risk factors to temporomandibular disorder symptoms have notbeen well established. OBJECTIVES: This study examined the association of temporomandibular disorder (TMD) symptoms with personality traits, psychological distress, somatisation and oral behaviours. The psychosocial and oral behavioural risk factors for TMD symptoms were also established in Asian young adults. METHODS: Participants were recruited from a large private University. Based on the quintessential five TMD symptoms (5Ts) of the DC/TMD, the participants were stratified into those with no (NT), painful (PT), dysfunctional (DT) and mixed (MT) TMD symptoms. Personality traits, psychological distress, somatisation and oral behaviours were evaluated with the Big Five Inventory-10 (BFI-10), Depression, Anxiety, Stress Scales-21 (DASS-21), Patient Health Questionnaire-15 (PHQ-15) and Oral Behaviours Checklist (OBC) accordingly. Data were examined using Kruskal-Wallis/Mann-Whitney U and Chi-squared tests, as well as multivariate logistic regression analysis (α = .05). RESULTS: Of the 420 young adults (mean age 22.7 ± 1.1 years) evaluated, 41.4% had no TMD symptoms, while 17.4%, 20.0% and 21.2% reported PT, DT and MT, respectively. Though personality traits did not vary notably, participants with MT and PT had significantly higher levels of negative affectivity, anxiety and stress than the NT group. Moreover, those with MT and PT presented significantly greater somatisation and more oral behaviours than the DT and NT groups. Multivariate regression analyses indicated that anxiety, somatisation, sleep-related and waking-state nonfunctional oral activities were associated with painful and/or dysfunctional TMD symptoms. CONCLUSIONS: Except for sleep-related oral activity, psychosocial and oral behavioural risk factors differed for painful, dysfunctional and mixed TMD symptoms in Asian young adults.

TMJ degenerative joint disease: relationships between CBCT findings, clinical symptoms, and signs.

OBJECTIVES: The relationships between cone-beam computed tomography (CBCT) findings, Temporomandibular disorder (TMD) symptoms, and signs were investigated in patients with TMJ degenerative joint disease (DJD). MATERIAL AND METHODS: Adult patients with Diagnostic Criteria for TMDs (DC/TMD)-defined intra-articular conditions were enrolled and subjected to CBCT assessment. The participants were organized into three groups, namely no (NT), early (ET), and late (LT) TMJ DJD based on radiographic findings. TMD symptoms/signs were appraised using the DC/TMD methodology. Statistical analyses were performed using Chi-square/non-parametric tests and Kappa statistics (α = 0.05). RESULTS: The mean age of the participants (n = 877) was 30.60 ± 11.50 years (86.6% women). NT, ET, and LT were observed in 39.7%, 17.0%, and 43.3% of the study sample. Significant differences in the prevalence of TMD symptoms (TMD pain, TMJ sounds, opening, and closing difficulty) and signs (TMD/TMJ pain, TMJ clicking/crepitus, and opening limitation) were discerned among the three groups (p ≤ .001). TMD/TMJ pain and opening difficulty/limitation were more prevalent in early rather than late degenerative changes. While moderate agreements between symptoms and signs were observed for TMD pain/opening limitation, the concurrence for TMJ sounds was fair. CONCLUSIONS: Young adults with TMJ sounds and pain should be examined with CBCT to establish the extent/progress of osseous changes.