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Observational Study
. 2020 Jan;99(3):e18686.
doi: 10.1097/MD.0000000000018686.

The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up

Kuei-Chen Lee  1   2 , Yung-Tsan Wu  2 , Wu-Chien Chien  3   4   5 , Chi-Hsiang Chung  3   4 , Liang-Cheng Chen  2 , Yi-Shing Shieh  1   6
Affiliations
Observational Study

The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up

Kuei-Chen Lee et al. Medicine (Baltimore). 2020 Jan.

Abstract

The coexistence of low back pain (LBP) and temporomandibular disorder (TMD) has often been noted clinically. However, studies of the association between these two conditions involving a large population with longitudinal evidences are lacking. Therefore, the study aimed to investigate the association between LBP and TMD in a nationwide-matched cohort population with a 15-year follow-up.Data of 65,121 patients newly diagnosed with LBP were analyzed, along with those of 195,363 (1:3) sex- and age-matched controls. Multivariate Cox regression analysis was used to determine TMD risk between the LBP and non-LBP groups. Kaplan-Meier method was used for determining the cumulative risk of first-onset TMD between groups, with a 15-year follow-up.The LBP group was more likely to develop first-onset TMD (adjusted hazards ratio (HR) = 1.561, P < .001), after adjusting for demographic variables and comorbidities. The risk factors for TMD were LBP, young age, higher insured premium, and osteoporosis. In the subgroup analysis, the LBP group had a higher risk of TMD than the non-LBP group in all stratifications.LBP is the risk factor contributing to the development of first-onset TMD. Therefore, clinicians should be reminded to manage LBP disorders concurrently when treating TMD.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of study sample selection from the National Health Insurance Research Database in Taiwan.
Figure 2
Figure 2
Kaplan-Meier for cumulative risk of first-onset TMD in patients aged 20 to 70 years stratified by low back pain with log-rank test. LBP = low back pain, TMD = temporomandibular disorder.
See this image and copyright information in PMC

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