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NCT Number: NCT04495777

Prevalence of Temporomandibular Disorders and Its Association With Oral Parafunctions, Neck Pain and Function

Purpose: To determine the prevalence of temporomandibular disorders (TMD) in female healthcare students and to assess its association with oral parafunctions, neck pain and function.

Methods: Female medical students will be included in the study on a voluntary basis using stratified sampling method according to the department they were being educated. The presence and severity of TMD will be assessed with the Fonseca's Anamnestic Index (FAI). The oral parafunctions will be self-reported with the Oral Behavior Checklist (OBC). The neck pain and function will be recorded with the Core Outcome Measure Index (COMI). A Chi-square test and Spearman correlation analysis will used for statistical analysis.

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Key information

Conditions

Temporomandibular Disorder Craniomandibular Disorders Jaw Diseases Joint Diseases Mandibular Diseases Muscular Diseases Musculoskeletal Diseases Neck Pain Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms Stomatognathic Diseases Temporomandibular Joint Disorders

Age range

18 year–35 year

Sex eligibility

Female

Study type

Observational

Primary location

Gul Oznur KARABICAK

Aydin, 09010, Turkey (Türkiye)

About this study

Temporomandibular disorder (TMD) has a multifactorial etiology related to parafunctional habits, emotional and psychological factors, trauma, posture, other musculoskeletal, or rheumatic disorders (1). Symptoms of TMD may include temporomandibular joint pain and clicks, headache, myofascial pain, decreased mandibular range of motion, masticatory muscle fatigue, limitation of mouth opening, pain when chewing, tinnitus, neuralgias, and bruxism (1,2). The severity of symptoms is related to the age and gender of the patients. Women showed a higher prevalence of TMD symptoms, with proportions varying from two to six women for each man, usually with ages between 20 and 40 years3. The distribution of age and gender in TMD, suggests a possible link between its pathogenesis and the female sex hormone, the estrogen, or between TMD and the mechanisms of pain modulation, as women show more sensitivity to most of the pain modalities (3,4) Epidemiologic studies showed that TMD prevalence in the students ranges from 50% to 77% (5-7). Several studies reported that a higher prevalence of TMD ranges from 47% to 81% in the Turkish student population (8-13). However, in some cases especially in students, the presence of TMD is asymptomatic. Therefore, the diagnosis of early symptoms and signs of TMD is crucial in preventing or minimizing TMD signs and symptoms (9).

Parafunctional habits such as bruxism, tooth clenching, gum chewing, biting foreign objects, and prolonged nail-biting might increase the risk of developing TMD (14). Even there are several studies examining the association of TMD and oral parafunctions in students (15-17); still, more studies are need to identify which oral behaviors cause TMD patients and healthy populations (18). Therefore, understanding the TMD symptoms in association with the oral parafunctions could provide different perspectives and an efficient treatment program (15).

To our knowledge, there is no study about TMD prevalence in female healthcare students and its association with oral parafunctions, neck pain, and function. The aims of this cross-sectional study were: (1) to evaluate the prevalence of TMD in female healthcare students and (2) to determine the association of TMD severity with oral parafunctional habits, neck pain and function.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • be Adnan Menderes University student
  • female gender
  • express consent to participate voluntarily in the study

Exclusion criteria

  • with recent trauma to head and face,
  • history of systematic diseases and neurological disorders
  • currently an ongoing orthodontic treatment

Treatment and study plan

Fonseca Anamnestic Index

Other

Fonseca Anamnestic Index was developed to assess the severity of temporomandibular disorders, based on its signs and symptoms. It has been proposed as a low cost and easy to apply alternative and has been used in screening for TMD in a non-patient population5. It was created with 10 items with 3 options of answers (specific scores): "yes (10 points)", "sometimes (5 points)" and "no (0 points)". The final score of the instrument is determined by the sum of the scores of all items, allowing the following classifications: the absence of signs and symptoms of TMD (0-15 points), mild TMD (20-45 points), moderate TMD (50-65 points), and severe TMD (70-100 points) (19).

Primary outcomes

  1. Fonseca Anamnestic Index

    Time frame: baseline

    Fonseca Anamnestic Index was developed to assess the severity of temporomandibular disorders, based on its signs and symptoms. It has been proposed as a low cost and easy to apply alternative and has been used in screening for TMD in a non-patient population5. It was created with 10 items with 3 options of answers (specific scores): "yes (10 points)", "sometimes (5 points)" and "no (0 points)". The final score of the instrument is determined by the sum of the scores of all items, allowing the following classifications: the absence of signs and symptoms of TMD (0-15 points), mild TMD (20-45 points), moderate TMD (50-65 points), and severe TMD (70-100 points) (19).

Secondary outcomes

  1. Oral parafunction

    Time frame: baseline

    Oral behaviors checklist is a self-report questionnaire for determining the frequency of oral parafunctional behaviors which are any abnormal behavior or functioning of the oral structures and associated muscles in the past one month. Original questionnaire consists of 21items, 2 items for oral behaviors during sleep, and 19 items for oral behaviors during waking hours. In this study the questionnaire was modified and two of the questions were exctracted due to study of Hayek et al25. Each item is scored from 0-4 based on the frequency of activity performed: a score of 0=none of the time; a score of 1=a little of the time; a score of 2=some of the time; a score of 3=most of the time and score of 4=all the time; with a range of 0-76 18.The sum of scoring had the following scheme: none = 0, low = 1-16, and high = 17-76 (20).

  2. Neck pain and function

    Time frame: baseline

    The COMI-neck is a short, self-administered outcome instrument consisting of just seven items to evaluate the five dimensions pain, neck-related function, symptom-specific well-being, general quality of life, and disability (social and work) (21,22). The two pain items use a 0-10 graphic rating scale; all other items use a 5-point adjective scale. For COMI summary score, each of the domain scores is transformed to a 0-10 scale and these are then averaged to give a score ranging from 0 to 10, with higher scores indicating a worse status (23).

Sponsors and collaborators

Lead sponsor

Aydin Adnan Menderes University

Other

Registry information

Official study title

Prevalence of Temporomandibular Disorders and Its Association With Oral Parafunctions, Neck Pain and Function in Female Turkish Healthcare Students: A Cross-Sectional Study

Important dates

Study start
2019
Primary completion
2020
Study completion
2020
First posted
Aug 3, 2020
Registry last updated
Aug 19, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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