Association of Temporomandibular Disorder Symptoms with Parafunctional Behaviors, Sleep Quality, Stress, and Anxiety Among Dental Educators and Students
Temporomandibular disorders (TMDs) are a collection of pain problems that affect the orofacial region. TMD is regarded as the second most widespread musculoskeletal disorder that causes disability and pain with a major impact on the patient’s quality of life. Its etiology is considered multifactorial and significantly related to genotype and phenotype; however, several risk factors predispose, precipitate, or prolong TMD. These are biological factors (e.g., sex hormones), age, endogenous opioid function, anatomical genotype differences, trauma, occlusal changes, systemic illness, parafunctions and psychosocial factors (e.g., exposure to stress, coping with pain, disasters, and emotions). Lifestyle habits and lifestyle choices have an undeniable impact on an individual’s health. A study by Lei J. et al.(2021) showed a moderate to strong cross-age relationship between stress, depression and anxiety and TMD. Also, in patients with painful TMD, a greater amount of stress and reduced quality of life have been reported precisely because of the symptoms of the disorder itself. Objective: In this cross-sectional study, a survey was conducted to collect primary data on oral parafunctional behaviors, sleep quality, anxiety and stress, and its association with symptoms of temporomandibular disorders in dental educators and students. Methods: The study population included all the dental graduates, undergraduates and active faculty at the Temple University, Kornberg School of Dentistry. The survey included three sections: a demographic section including questions on age, gender, race/ethnicity and current position at the dental school; the TMD symptom questionnaire, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to screen for the presence of TMD symptoms in the study participants; Oral behavioral checklist, Patient-Reported Outcomes Measurement Information Systems (PROMIS), General Anxiety Disorder-7(GAD-7) and Perceived Stress Scale (PSS)questionnaires was used to assess oral parafunctional behaviors, sleep quality, anxiety and stress among the study population. Mean, standard deviation (SD), and percentage (%) were computed for descriptive analysis. Chi-square and one-way ANOVA tests were conducted to determine whether there is a significant difference in sleep quality, stress, anxiety, and parafunctional behavior with the TMD symptom assessment status. Multivariable analyses were conducted to assess the association between positive temporomandibular disorder status and various individual characteristics, such as age, gender, year at dental school, sleep quality, stress, anxiety, and oral parafunctional behaviors. SPSS version 28.0 was used to analyze the data and a p-value equal to or less than 0.05 was considered statistically significant. Results: In total 62 completed online surveys were submitted. Participants with positive TMD symptoms were younger than those without positive symptoms (P<0.05). Dental students/residents (n=18) reported positive TMD symptoms more than the dental faculty (n=6) in the school (P<0.05). There were no statistically significant differences between means of the two groups of Dental Students/Residents and Dental Faculty among their total OBC, PROMIS, GAD-7, and PSS scores (P>0.05). According to the multiple logistic regression, oral parafunctional behavior could significantly predict the presence of positive TMD symptoms. Participants with one unit increase in their parafunctional behavior were 1.2 times more likely to show positive TMD symptoms in this study (P<0.05). Conclusions: Higher parafunctional behavior was the only significant predictor for exhibiting positive TMD symptoms among dental students/residents and faculty participating in this study while controlling for demographic variables.
Dentistry, Anxiety, Faculty and students, Oral parafunctional behavior, Sleep quality, Stress, Temporomandibular disorder
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