Temporomandibular disorder subtypes, emotional distress, impaired sleep, and oral health-related quality of life in Asian patients

Abstract

Objectives: This study determined the differences in emotional states, sleep and oral health-related quality of life (OHRQoL) between patients with pain-related and intra-articular Temporomandibular disorders (TMDs), and associated emotional symptoms with sleep and OHRQoL.

Methods: Participants were recruited from a tertiary TMDs referral centre. The Depression, Anxiety, Stress Scales-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI) and Oral Health Impact Profile-TMDs (OHIP-TMDs) were used to assess emotional states, sleep and Oral health-related quality of life (OHRQoL), respectively. TMD-related and sociodemographic data were also gathered. Patients were divided into pain-related (PT), intra-articular (IT) and combined TMDs (CT) groups based on the Diagnostic Criteria for TMDs. Data were analysed using one-way ANOVA, Chi-square test, Pearson's correlation and logistic regression analysis with the significance level set at P < .05.

Results: Data from 1079 participants with a mean age of 29.6 ± 14.2 years were appraised (93.3% response rate). The severity/prevalence of emotional distress, impaired sleep and OHRQoL of the PT/CT groups were higher than the IT group. Moderate-to-strong inter-relationships between emotional, sleep and OHRQoL variables were more explicit for participants with painful TMDs. Logistic regression analysis demonstrated that painful TMDs were associated with higher stress and poorer OHRQoL with odds ratios (ORs) of 1.482 (95% CI 1.039-2.114) and 6.502 (95% CI 3.201-13.210), respectively.

Conclusions: Painful TMDs are associated with higher levels of emotional distress, sleep and OHRQoL impairments. Routine evaluation of the biopsychosocial distress, especially stress and life quality, is necessary for patients with painful TMDs.

Keywords: emotions; oral health; quality of life; sleep disturbance; temporomandibular disorders.