Relationship between Symptoms and Psychological Status of Temporo-Mandibular Disorders

Objectives: To examine the relationship between detrimental oral parafunctions, psychosocial factors (emotional stress, depression, anxiety, and somatization) and symptoms of temporomandibular disorders (TMD) among a random adult population, and to analyze age and gender differences in the psychosocial status, parafunctional activity and the prevalence of TMD symptoms. Methods: The study consisted of 240 adults (103 males, 127 females, mean age 35.7±12.5 years) who filled out a questionnaire regarding TMD symptoms, and answered all psychosocial items of the AXIS II of the Research Diagnostic Criteria for TMD and of the Perceived Stress Scale. Results: Significant differences were found in the level of psychosocial factors among females who did not suffer from chronic pain compared to males. Significant values were stress (p=0.001), depression, anxiety, and somatization (p<0.001). The same gender tendency was found in subjects suffering from pain, but differences were not significant. A positive statistical significant relation was found between the prevalence of reported sleep bruxism to the increased stress scale (p=0.03) and anxiety (p=0.042), as well as between higher prevalence of awake clenching to stress scale (p=0.001), depression (p=0.047) and anxiety (p=0.019). No gender or age differences were found in the prevalence of TMD symptoms or in the performance of oral parafunctions. Jaw play was significantly correlated statistically with perceived tension in the TM joint (p=0.005). Conclusions: Females suffer from more severe psychosocial factors than males, but when chronic pain exists, discrepancy between genders is less prominent, possibly indicating that pain is an important factor in the development of psychosocial factors in males. Sleep bruxism and awake clenching are positively correlated with psychosocial factors. TMD symptoms have no gender or age preference. Jaw play is related to TMJ internal derangement.