Association Between Clinical Signs of Temporomandibular Disorders and Psychological Distress Among an Adult Finnish Population

Aims: To evaluate the association between signs of temporomandibular disorders (TMD) and psychological distress in a general population-based sample of Finnish adults. Methods: The Health 2000 Survey was conducted in 2000-2001 by the National Institute for Health and Welfare in Finland. Of the sample of adults aged 30 or over (n = 8,028), 79% participated in a clinical oral health examination, which included examination of TMD signs. The participants (n = 6,155) also completed questionnaires, including the 12-item General Health Questionnaire (GHQ-12), which measured psychological distress. Associations between TMD signs and psychological distress measured by the GHQ-12 were examined in both genders. Statistical measures included chi-square tests, t tests, and logistic regression analyses. Results: The prevalence of the TMD signs (limited opening, clicking, crepitation, temporomandibular joint [TMJ] palpation pain, and muscle palpation pain) was 11.2%, 17.6%, 10.5%, 5.1%, and 18.9% in women, and 6.1%, 12.9%, 5.3%, 2.4%, and 7.2% in men, respectively. High GHQ-12 scores, measured as continuous variables and in quartiles by distress level, were significantly associated with masticatory muscle pain on palpation in both genders (P .05) and with TMJ pain on palpation in women (P .05). Additionally, high GHQ-12 scores as continuous were associated with TMJ crepitation in men (P .05). The logistic regression analyses showed that higher GHQ-12 scores were associated significantly with masticatory muscle pain on palpation both in women (odds ratio [OR] = 2.18; 95% confidence interval [CI] = 1.6-2.9) and men (OR = 2.03; 95% CI = 1.3-3.1). Conclusion: TMD signs and psychological distress appear to be associated. However, due to the limitations of the study, the findings can be regarded as preliminary. Keywords: GHQ, Health 2000 Survey, psychological distress, temporomandibular disorders, TMD