Comorbidities and associated factors of painful temporomandibular disorder symptoms in the BigMouth Dental Data Repository
Caroline M. Sawicki, Linda SangalliAbstract
Introduction/Objectives:
Temporomandibular disorders (TMD) are associated with multiple comorbidities; however, specific comorbidities may be differentially associated with painful and nonpainful TMD. We describe the prevalence of TMD symptoms, quantified associated comorbidities, and identified associated factors of painful TMD symptoms in a large database.
Methods:
Data were extracted from BigMouth repository (January 2014–May 2025) for adults with responses to TMD-related items of “pain upon chewing/talking/jaw use” (used to classify patients into self-reported “painful” vs “nonpainful TMD symptoms”), “jaw popping/clicking,” and “jaw locking.” Associations between painful TMD and comorbidities were calculated with χ 2 tests and prevalence ratios (PRs). Logistic regression identified factors associated with painful TMD symptoms.
Results:
Of 259,768 patients (46.5 ± 17.8 years old, 51.4% women), common symptoms were tooth grinding (21.3%), headaches (23.3%), pain on chewing (9.5%), temporomandibular joint noises (21.6%), and jaw locking (3.1%). Compared with those with nonpainful TMD, those with self-reported painful TMD symptoms had significantly higher prevalence of headaches (38.8% vs 16.1%, PR = 2.41, 95% confidence interval [CI] 2.36–2.46), arthritis (19.4% vs 16.1%, PR = 1.20, 95% CI 1.15–1.26), depression (34.7% vs 18.1%, PR = 1.91, 95% CI 1.84–1.98), anxiety (29.9% vs 21.8%, PR = 1.37, 95% CI 1.31–1.43), sleep apnea (17.7% vs 9.1%, PR = 1.95, 95% CI 1.86–2.05), and gastrointestinal issues (16.4% vs 9.8%, PR = 1.67, 95% CI 1.58–1.77, all
Conclusion:
Painful TMD is strongly associated with psychological and somatic comorbidities. Accumulation of somatic comorbidities increases TMD risk, highlighting the need of integrated medical-dental approaches to TMD care.