Association Between Temporomandibular Disorders and Psychological Distress Among Finnish Population

Objectives: Temporomandibular disorders (TMD) have multifactorial background, including psychological factors. The aim of the study was to evaluate the association between TMD signs and psychological distress in a general population based sample of Finnish adults.
Methods: The Health 2000 Survey was carried out in 2000-2001 by the National Institute for Health and Welfare in Finland. Of the sample including adults 30 years or over (n=8,028), 79% participated in clinical oral health examination, which included examination of TMD signs. Participants (n=6,155) also filled in a questionnaire, including 12-item General Health Questionnaires (GHQ-12), measuring psychological distress. Associations between TMD signs and GHQ-12 scores were examined in both genders.
Results: Prevalence of TMD signs (limited opening, clicking, crepitation, TMJ palpation pain and muscle palpation pain) was 11%, 18%, 11%, 5% and 19% in women, and 6%, 13%, 5%, 2% and 7% in men, respectively. High GHQ-12 scores, measured as both classified or continuous, were significantly associated with masticatory muscle pain on palpation in both genders (p<0.05) and with TMJ pain on palpation in women (p<0.05). Additionally, GHQ-12 scores as continuous associated with TMJ crepitation in men (p<0.05).
The logistic regression analyses showed that higher GHQ-12 scores associated significantly with masticatory muscle pain on palpation both among women (OR =2.2, 95% CI=1.6-2.9) and men (OR=2.0, 95% CI=1.3-3.1).
Conclusions: Clinical TMD signs and psychological distress associate at general population level. These findings emphasize the importance of psychological aspects in TMD and their consideration in the treatment of TMD.