Relationships between Parafunctions, Emotional Stress and TMD on Dental Students

Introduction: Various psychosocial factors, including stress and oral parafunctions, play an important role in the etiology of Temporo-Mandibular Disorders (TMD). Objectives: To examine the relationship between oral parafunctions, emotional stress, and TMD among undergraduate dental students. Methods: Questionnaires regarding signs and symptoms of TMD, the AXIS II component of the RDC/TMD (measuring mainly depression, anxiety and somatization), and the Perceived Stress Scale (measuring emotional stress), were completed by 200 dental students in the 1st to 6th years of their studies. Results: 32.7% of the students reported at least one TMD symptom. A significant increase in the scales of stress, depression, anxiety and in the amount of parafunctional activity was found in the 4th and 5th years of studies, as compared to the students studying in the 1st, 2nd 3rd and 6th years. A positive relation was found between the increased depression and anxiety and the higher prevalence of clenching (p=0.009), and myofascial pain (p=0.007). Conclusions: The practical training in the 4th and 5th years of the dental studies is accompanied by high levels of stress, anxiety and depression on the part of the students. These parameters demonstrated a strong relationship to TMD signs and symptoms and to parafunctional activities.