Impact of smartphone addiction on temporomandibular disorders through oral behaviors and psychological factors in university students.

BACKGROUND

Temporomandibular disorders (TMD) are multifactorial conditions associated with psychological and behavioral factors. This study examined pathways linking smartphone addiction to TMD using structural equation modeling (SEM).

METHODS

A cross-sectional online survey was conducted among 856 university students. TMD was assessed using the Fonseca Anamnestic Index, and smartphone addiction using the Smartphone Addiction Scale-Short Version. Oral behaviors and psychological factors were also evaluated. Exploratory and confirmatory factor analyses were performed before SEM analysis.

RESULTS

TMD prevalence was 56.4% and was higher among females (p < 0.001). Smartphone addiction scores were significantly higher in the TMD group (28.03±7.74 vs. 23.80±8.42, p < 0.001). SEM showed that psychological distress (β = 0.31), oral parafunction (β = 0.26), and oral habits (β = 0.15) were directly associated with TMD. Smartphone addiction had significant indirect effects through psychological distress (β = 0.19) and oral habits (β = 0.11) (p < 0.001).

CONCLUSION

Smartphone addiction was indirectly associated with TMD through psychological distress and maladaptive oral behaviors.