The Role of Biologic Sex in Temporomandibular Disorder Subtypes: A Cross-Sectional Study in A Southern Brazilian Population.

PURPOSE: To assess the prevalence and role of biologic sex as a risk indicator for the development of temporomandibular disorder (TMD) subtypes.

MATERIALS AND

METHODS

This population-based crosssectional study randomly sampled subjects attending the public health system in the city of Maringá, Brazil. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I was used to classify TMD subtypes, and RDC/TMD Axis II was used to assess Graded Chronic Pain Scale (GCPS), depression, somatization with or without pain, sociodemographic data, oral and general health, and pain history. Sleep quality was assessed by the Sleep Assessment Questionnaire (SAQ).

RESULTS

TMDs in the selected sample (n = 1,643, 65.85% women) were significantly more prevalent in women compared to men: (a) GCPS moderately/ severely limiting (6.3% vs 2.9%), (b) muscle diagnoses (34.0% vs 20.7%), and (c) disc displacements (9.0 vs 5.2). Psychologic-related disorders were also significantly more prevalent in women: (a) depression (53.0% vs 33.5%), (b) somatization without pain (48.5% vs 32.8%), and (c) somatization with pain (55.5% vs 34.4%), but not significant for sleep quality (56.0% vs 58.6%). TMD pain was predominantly chronic, recurrent, and significantly higher in women than in men (78.2% vs 67.6%, P < .01). Female sex significantly increased the risk (adjusted odds ratio) of developing TMD by 70% for moderately and severely limiting GCPS, 50% for developing TMD muscle diagnoses, and 70% for disc displacements, even after controlling for psychologicand sociodemographic-related variables.

CONCLUSIONS

Sex does play a role in the development of TMD subtypes (muscle diagnoses and disc displacements) and chronicity.