Is there a link between diet and painful temporomandibular disorders? A cross-sectional study.

BACKGROUND

Nutrition and diet have emerged as potentially modifiable factors in the management of chronic pain, however, there is still limited evidence regarding the direct relationship between diet, nutrition, and Temporomandibular disorders (TMD). The aim of this cross-sectional study was to explore the relationship between dietary patterns and painful TMD, with a particular focus on dietary inflammatory potential, adherence to the Mediterranean diet, and psychosocial predictors.

METHODS

Ninety-two participants (45 TMD patients and 47 controls) aged 20–50 were recruited in Portugal and Spain. TMD diagnosis was based on the Diagnostic Criteria for TMD (DC/TMD). Psychosocial status was assessed using PHQ-9 (depression), PHQ-15 (somatic symptoms), and the Oral Behavior Checklist (OBC). Dietary data were collected through a 24-hour recall and assessed using the Healthy Eating Index (HEI), Dietary Inflammatory Index (DII), and Mediterranean Diet Adherence Screener (MEDAS). Pressure pain thresholds (PPT) were recorded at the TMJ and masticatory muscles. Data was analyzed using independent t-tests, Mann-Whitney U, and OPLS-DA multivariate modeling.

RESULTS

TMD patients showed significantly higher scores for somatic symptoms, depressive symptoms, and maladaptive oral behaviors. While no significant differences were found for DII or MEDAS scores between groups, TMD patients had significantly lower HEI scores and PPTs values in the masseter, temporalis, and TMJ regions. OPLS-DA identified oral behaviors, somatic symptoms, and lower HEI as the strongest predictors distinguishing TMD patients from controls.

CONCLUSIONS

Painful TMD is associated with higher psychosocial distress and poorer dietary quality. These findings underscore the need to include dietary assessment in the clinical evaluation and management of TMD.