Prevalence of Temporomandibular Disorders and Its Association With Oral Parafunctions, Neck Pain and Function
Condition: Temporomandibular Disorder; Neck Pain
MeSH terms: Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome; Neck Pain
Study type: Observational

Summary: 
      Purpose: To determine the prevalence of temporomandibular disorders (TMD) in female
      healthcare students and to assess its association with oral parafunctions, neck pain and
      function.

      Methods: Female medical students will be included in the study on a voluntary basis using
      stratified sampling method according to the department they were being educated. The presence
      and severity of TMD will be assessed with the Fonseca's Anamnestic Index (FAI). The oral
      parafunctions will be self-reported with the Oral Behavior Checklist (OBC). The neck pain and
      function will be recorded with the Core Outcome Measure Index (COMI). A Chi-square test and
      Spearman correlation analysis will used for statistical analysis.
    

Detailed description: 
      Temporomandibular disorder (TMD) has a multifactorial etiology related to parafunctional
      habits, emotional and psychological factors, trauma, posture, other musculoskeletal, or
      rheumatic disorders (1). Symptoms of TMD may include temporomandibular joint pain and clicks,
      headache, myofascial pain, decreased mandibular range of motion, masticatory muscle fatigue,
      limitation of mouth opening, pain when chewing, tinnitus, neuralgias, and bruxism (1,2). The
      severity of symptoms is related to the age and gender of the patients. Women showed a higher
      prevalence of TMD symptoms, with proportions varying from two to six women for each man,
      usually with ages between 20 and 40 years3. The distribution of age and gender in TMD,
      suggests a possible link between its pathogenesis and the female sex hormone, the estrogen,
      or between TMD and the mechanisms of pain modulation, as women show more sensitivity to most
      of the pain modalities (3,4) Epidemiologic studies showed that TMD prevalence in the students
      ranges from 50% to 77% (5-7). Several studies reported that a higher prevalence of TMD ranges
      from 47% to 81% in the Turkish student population (8-13). However, in some cases especially
      in students, the presence of TMD is asymptomatic. Therefore, the diagnosis of early symptoms
      and signs of TMD is crucial in preventing or minimizing TMD signs and symptoms (9).

      Parafunctional habits such as bruxism, tooth clenching, gum chewing, biting foreign objects,
      and prolonged nail-biting might increase the risk of developing TMD (14). Even there are
      several studies examining the association of TMD and oral parafunctions in students (15-17);
      still, more studies are need to identify which oral behaviors cause TMD patients and healthy
      populations (18). Therefore, understanding the TMD symptoms in association with the oral
      parafunctions could provide different perspectives and an efficient treatment program (15).

      To our knowledge, there is no study about TMD prevalence in female healthcare students and
      its association with oral parafunctions, neck pain, and function. The aims of this
      cross-sectional study were: (1) to evaluate the prevalence of TMD in female healthcare
      students and (2) to determine the association of TMD severity with oral parafunctional
      habits, neck pain and function.
    

Intervention name(s): Fonseca Anamnestic Index
Intervention type(s): Other
Intervention description(s): Fonseca Anamnestic Index was developed to assess the severity of temporomandibular disorders, based on its signs and symptoms. It has been proposed as a low cost and easy to apply alternative and has been used in screening for TMD in a non-patient population5. It was created with 10 items with 3 options of answers (specific scores): "yes (10 points)", "sometimes (5 points)" and "no (0 points)". The final score of the instrument is determined by the sum of the scores of all items, allowing the following classifications: the absence of signs and symptoms of TMD (0-15 points), mild TMD (20-45 points), moderate TMD (50-65 points), and severe TMD (70-100 points) (19).
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        University students who are currently ongoing their education in healthcare department
      
Keywords: temporomandibular; students; prevalence; parafunctional habit; neck pain