Functional and psychosocial impact related to specific temporomandibular disorder diagnoses

Comparing the level of impaired oral health-related quality of life (OHRQoL) in patients with a specific temporomandibular disorder (TMD) diagnosis to general population subjects unaffected by TMD to derive the unique functional and psychosocial impact due to TMD.

A sample of 471 consecutive treatment seeking adult patients with at least one physical (axis I) TMD diagnosis according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) was included in this study. OHRQoL was measured using the oral health impact profile (OHIP). To derive functional and psychosocial impact due to TMD mean OHIP scores were calculated from adult subjects of a regional population sample without any RDC/TMD axis I diagnosis (N=135) from which a subgroup without any sign/symptom according to the Helkimo-index (N=35) was derived. These means were subtracted from mean OHIP scores of the TMD patients.

All TMD patients with a single axis I diagnosis presented much higher impaired OHRQoL (OHIP means: 27.5-56.2) compared to general population subjects (9.7 in subjects without any TMD sign/symptom and 14.8 in those without RDC/TMD axis I diagnosis). Group I diagnosis (myofascial pain) showed the highest OHRQoL impact with the lowest in patients with group II diagnosis (disc displacement). Patients with two pain-related diagnoses had significantly higher impaired OHRQoL than patients with a single one (58.9 versus 49.2, p=0.03).

All TMD axis I diagnoses have significant impact on OHRQoL. Subjects with pain-associated conditions present higher scores than those without pain. Patients with two pain-related diagnoses have more impaired OHRQoL than subjects with one diagnosis.