Temporomandibular disorders a reported to affect up to 12% of the population although a recent review (Dental Elf – 3rd Feb 2021) reports a prevalence in adults of 29.3% (95%CI: 6.1–72.3%) with wide confidence intervals. Temporomandibular disorders are associated with pain, discomfort and restricted jaw movements which may impact on oral health related quality of life.
The aim of this review was to assess the impact of temporomandibular disorders (TMD) on oral health related quality of life (OHRQoL).
Method
A protocol was registered with the PROSPERO database. Searches were undertaken in the Cochrane Library, PubMed, Scopus and Google Scholar databases. Cross -sectional studies of patients diagnosed with TMD where OHRQoL was assessed using a standardised method were considered. Studies publish in languages other than English were excluded. Two reviewers screened and selected studies and extracted data. Study quality was assesses using the modified Newcastle Ottawa scale (NOS) for case–control and cross-sectional studies. Data was presented as mean difference (MD) with 95% confidence interval (CI) and a meta-analysis conducted.
Results
- 8 studies were included.
- 2 studies were from Brazil and the Middle East and one each from England, Finland, Germany and India.
- 4 studies used the Oral Health Impact Profile-14 (OHIP-14)
- 5 studies were considered to have a low risk of bias and 3 some concerns.
- OHRQoL tools used included the Oral Health Impact Profile-14 (OHIP-14), the Short-Form 36 Health Survey (SF-36) and the OHIP- 49.
- 6 studies (1043 TMD patients, 2661 controls) contributed to the meta-analysis which showed a significantly higher OHRQoL score in TMD cases MD= 6.60 (95%CI; 2.17 to 11.03).
Conclusions
The authors concluded: –
The impact of OHRQoL on the management of TMD was deemed to be significant. The comprehensive management of TMD should consider the impact of the condition on the individual’s daily life and incorporate interventions that address both the physical and psychological aspects of the condition. By improving OHRQoL, individuals with TMD can experience improved overall well-being and quality of life.
Comments
A previous 2010 review by Dahlström and Carlsson included 12 studies and indicated that TMDs negatively affected OHRQoL. This new review used a pre-registered protocol and searched several major databases however restricting the inclusions to English language publications may have excluded some relevant studies. All the included studies are cross-sectional in nature so cannot establish a causal relationship they are also more prone to bias than other study designs. The findings indicated that OHRQoL is poorer in patients with TMD however variations in the tools used to diagnose TMD and assess OHRQoL contributes to very high heterogeneity in the meta-analysis.
Links
Primary Paper
Qamar Z, Alghamdi AMS, Haydarah NKB, Balateef AA, Alamoudi AA, Abumismar MA, Shivakumar S, Cicciù M, Minervini G. Impact of temporomandibular disorders on oral health-related quality of life: A systematic review and meta-analysis. J Oral Rehabil. 2023 Aug;50(8):706-714. doi: 10.1111/joor.13472. Epub 2023 May 3. PMID: 37078711.
Other references
Dahlström L, Carlsson GE. Temporomandibular disorders and oral health-related quality of life. A systematic review. Acta Odontol Scand. 2010 Mar;68(2):80-5. doi: 10.3109/00016350903431118. PMID: 20141363.
Dental Elf – 3rd Feb 2021
Picture Credits
Photo by engin akyurt on Unsplash
