Awake oral behaviors associated with temporomandibular-related pain symptoms in a non-patient student population-a dual assessment approach.

BACKGROUND

It is unclear which oral behaviors are harmless and which might become harmful when performed excessively. This study aimed to determine which awake oral behaviors are associated with Temporomandibular Disorder (TMD)-related pain symptoms in a non-patient population.

METHODS

Subjects' awake oral behaviors were assessed through: (i) Oral Behavior Checklist (OBC), a single-point self-report questionnaire that quantifies the frequency of awake functional and non-functional oral behaviors; and (ii) Ecological Momentary Assessment (EMA), a designated smartphone application which enabled real-time repeated data collection of oral behaviors throughout the day, for multiple days. 118 participants (62.7% female) completed both the OBC and EMA assessment modes. Subjects were allocated into two groups: (i) subjects with TMD-related pain symptoms (TMDPS, N = 34, 85.29% female); and (ii) subjects without TMD-related pain symptoms (noTMDPS, N = 84, 53.57% female).

RESULTS

TMDPS subjects performed more awake oral behaviors compared to noTMDPS subjects. EMA behaviors that showed a significant predictive ability of masticatory muscle pain in binomial logistic regressions were entered into a multiple logistic regression model. Results show that teeth grinding increased the odds of subjects belonging to the TMDPS group by 22%. The final logistic regression demonstrated acceptable fit (Nagelkerke's R2 = 0.232). In a multiple regression model evaluating the predictive ability of OBC behaviors, the final model showed a Nagelkerke's R2 of 0.468. In addition to sex, three OBC behaviors came out as significant predictors in the final model: teeth grinding increased the odds of subjects belonging to the TMDPS group by 85%; holding or jutting the jaw increased the odds by 82%, and clenching increased the odds by 67%.

CONCLUSIONS

Reports of teeth clenching, holding or jutting jaw forward or to the side, and teeth grinding may be associated with the report of TMD-related pain symptoms in a non-patient student population.