Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Psychological Status and Oral Health-Related Quality of Life of Patients with Temporomandibular Joint Disorder: A Cross-Sectional Clinical Study
Temporomandibular Eklem Bozukluğu Olan Hastaların Psikolojik Durumu ve Ağız Sağlığı ile İlişkili Yaşam Kalitesi: Kesitsel Bir Klinik Çalışma
Ömer EKİCİa
aDepartment of Oral and Maxillofacial Surgery, Afyonkarahisar University of Health Sciences Faculty of Dentistry, Afyonkarahisar, TURKIYE
Turkiye Klinikleri J Dental Sci. 2022;28(1):13-20
doi: 10.5336/dentalsci.2021-83642
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study is to examine the association of psychological factors such as stress, anxiety, and depression with the quality of life in patients with temporomandibular disorder (TMD). Material and Methods: This cross-sectional clinical study was carried out on 375 patients with temporomandibular joint disorder in Oral and Maxillofacial Surgery Clinic of Afyonkarahisar University of Health Sciences Faculty of Dentistry. While the stress level of the participants was evaluated with the Perceived Stress Scale-14, the levels of anxiety and depression were evaluated using the Beck Anxiety and Beck Depression Scales. Participants' quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14). SPSS for Windows 21.0 program was used for statistical analyses. Results were evaluated in 95% confidence interval, at p<0.05 and p<0.001 significance levels. Results: The OHIP-14 scale mean score of the participants was 17.42. In this study, the highest scores were observed in the OHIP-14 sub-dimensions of 'physical pain (3.97±2.22)' and 'psychological disturbance (3.02±2.09)'. Both the total OHIP-14 score and the OHIP-14 sub-dimension scores increased significantly as the levels of stress, anxiety and depression increased (p<0.05). Conclusion: These study findings revealed that stress, anxiety, and depression level were positively and strongly correlated with quality of life in patients with TMD. Therefore, it should be taken into consideration in the psychosocial parameters in the treatment of the disease and improving the quality of life.

Keywords: Stress; anxiety; depression; temporomandibular joint disorder; quality of life
ÖZET
 Amaç: Bu çalışmanın amacı, temporomandibular bozukluğu (TMB) olan hastalarda stres, anksiyete ve depresyon gibi psikolojik faktörlerin yaşam kalitesi ile ilişkisini incelemektir. Gereç ve Yöntemler: Bu kesitsel klinik çalışma, Afyonkarahisar Sağlık Bilimleri Üniversitesi Diş Hekimliği Fakltesinin Ağız ve Çene Cerrahisi Kliniğinde temporomandibular eklem bozukluğu olan 375 hasta üzerinde gerçekleştirildi. Katılımcıların stres düzeyleri Algılanan Stres Ölçeği- 14 ile değerlendirilirken, anksiyete ve depresyon düzeyleri Beck Anksiyete ve Beck Depresyon Ölçekleri ile değerlendirildi. Katılımcıların yaşam kalitesi ise Ağız Sağlığı Etki Profili-14 [Oral Health Impact Profile-14 (OHIP-14)] ile değerlendirildi. İstatistiksel analizler için SPSS 21.0 programı kullanıldı. Sonuçlar %95'lik güven aralığında, p<0,05 ve p<0,001 anlamlılık düzeyinde değerlendirildi. Bulgular: Katılımcıların OHIP-14 ölçeği ortalama puanı 17,42 idi. Bu çalışmada, en yüksek puanlar 'fiziksel ağrı (3,97±2,22)' ve 'psikolojik rahatsızlık (3,02±2,09)' OHIP-14 alt boyutlarında gözlendi. Stres, anksiyete ve depresyon düzeyleri arttıkça hem toplam OHIP-14 puanı hem de OHIP-14 alt boyut puanları anlamlı olarak arttı (p<0,05). Sonuç: Bu çalışma bulguları, TMB hastalarında stres, anksiyete ve depresyon düzeyinin yaşam kalitesi ile pozitif ve güçlü bir şekilde ilişkili olduğunu ortaya koymuştur. Bu nedenle hastalığın tedavisinde ve yaşam kalitesinin yükseltilmesinde psikososyal parametreler dikkate alınmalıdır.

Anahtar Kelimeler: Stres; kaygı; depresyon; temporomandibular eklem bozukluğu; yaşam kalitesi
REFERENCES:
  1. Miettinen O, Lahti S, Sipilä K. Psychosocial aspects of temporomandibular disorders and oral health-related quality-of-life. Acta Odontol Scand. 2012;70(4):331-6. [Crossref]  [PubMed]  [PMC] 
  2. Durham J, Steele JG, Wassell RW, Exley C, Meechan JG, Allen PF, et al. Creating a patient-based condition-specific outcome measure for Temporomandibular Disorders (TMDs): Oral Health Impact Profile for TMDs (OHIP-TMDs). J Oral Rehabil. 2011;38(12):871-83. [Crossref]  [PubMed] 
  3. Segù M, Collesano V, Lobbia S, Rezzani C. Cross-cultural validation of a short form of the Oral Health Impact Profile for temporomandibular disorders. Community Dent Oral Epidemiol. 2005;33(2):125-30. [Crossref]  [PubMed] 
  4. Rai B, Kaur J. Association between stress, sleep quality and temporomandibular joint dysfunction: simulated Mars mission. Oman Med J. 2013;28(3):216-9. Retraction in: Oman Med J. 2020;35(5):e176. [Crossref]  [PubMed]  [PMC] 
  5. Caglayan F, Altun O, Miloglu O, Kaya MD, Yilmaz AB. Correlation between oral health-related quality of life (OHQoL) and oral disorders in a Turkish patient population. Med Oral Patol Oral Cir Bucal. 2009;14(11):e573-8. [PubMed] 
  6. Oliveira LK, Almeida Gde A, Lelis ÉR, Tavares M, Fernandes Neto AJ. Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals. Braz Oral Res. 2015;29:S1806-83242015000100265. [Crossref]  [PubMed] 
  7. Manfredini D, Winocur E, Ahlberg J, Guarda-Nardini L, Lobbezoo F. Psychosocial impairment in temporomandibular disorders patients. RDC/TMD axis II findings from a multicentre study. J Dent. 2010;38(10):765-72. [Crossref]  [PubMed] 
  8. Tjakkes GH, Reinders JJ, Tenvergert EM, Stegenga B. TMD pain: the effect on health related quality of life and the influence of pain duration. Health Qual Life Outcomes. 2010;8:46. [Crossref]  [PubMed]  [PMC] 
  9. Shueb SS, Nixdorf DR, John MT, Alonso BF, Durham J. What is the impact of acute and chronic orofacial pain on quality of life? J Dent. 2015;43(10):1203-10. [Crossref]  [PubMed] 
  10. Murray H, Locker D, Mock D, Tenenbaum HC. Pain and the quality of life in patients referred to a craniofacial pain unit. J Orofac Pain. 1996;10(4):316-23. [Link] 
  11. John MT, Reissmann DR, Schierz O, Wassell RW. Oral health-related quality of life in patients with temporomandibular disorders. J Orofac Pain. 2007;21(1):46-54. [PubMed] 
  12. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-55. [PubMed] 
  13. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7. [Crossref]  [PubMed] 
  14. Ulusoy M, Sahın N, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric Properties. J Cogn Psychother. 1998;12(2):163,172. [Link] 
  15. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-96. [Crossref]  [PubMed] 
  16. Eskin M, Demirkiran F. The Adaptation of the Perceived Stress Scale into Turkish: A Reliability and Validity Analysis Validity of LPFS and SCID Personality Disorder Diagnoses in Turkey View Project Zihinsel Engelli Çocuğa Sahip Annelerin Bakım Yükü, Depresyon ve Öz Yeterlilik Algılarının İncelenmesi View Project. [Link] 
  17. TOAD [İnternet]. [Erişim tarihi: 28 Haziran 2020]. Beck Depresyon Envanteri. Erişim linki: [Link] 
  18. Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994;11(1):3-11. [PubMed] 
  19. Suvinen TI, Reade PC, Kemppainen P, Könönen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain. 2005;9(6):613-33. [Crossref]  [PubMed] 
  20. Locker D, Allen F. What do measures of 'oral health-related quality of life' measure? Community Dent Oral Epidemiol. 2007;35(6):401-11. [Crossref]  [PubMed] 
  21. Dahlström L, Carlsson GE. Temporomandibular disorders and oral health-related quality of life. A systematic review. Acta Odontol Scand. 2010;68(2):80-5. [Crossref]  [PubMed] 
  22. Rener-Sitar K, Celebić A, Mehulić K, Petricević N. Factors related to oral health related quality of life in TMD patients. Coll Antropol. 2013;37(2):407-13. [PubMed] 
  23. Bayat M, Abbasi AJ, Noorbala AA, Mohebbi SZ, Moharrami M, Yekaninejad MS. Oral health-related quality of life in patients with temporomandibular disorders: A case-control study considering psychological aspects. Int J Dent Hyg. 2018;16(1):165-70. [Crossref]  [PubMed] 
  24. Almoznino G, Zini A, Zakuto A, Sharav Y, Haviv Y, Hadad A, et al. Oral Health-Related Quality of Life in Patients with Temporomandibular Disorders. J Oral Facial Pain Headache. 2015 Summer;29(3):231-41. Erratum in: J Oral Facial Pain Headache. 2015;29(4):330. Avraham, Hadad [corrected to Hadad, Avraham]; Noam, Yarom [corrected to Yarom, Noam]. [Crossref]  [PubMed] 
  25. Schierz O, John MT, Reissmann DR, Mehrstedt M, Szentpétery A. Comparison of perceived oral health in patients with temporomandibular disorders and dental anxiety using oral health-related quality of life profiles. Qual Life Res. 2008;17(6):857-66. [Crossref]  [PubMed] 
  26. Blanco-Aguilera A, Blanco-Aguilera E, Serrano-Del-Rosal R, Biedma-Velázquez L, Rodriguez-Torronteras A, Segura-Saint-Gerons R, et al Influence of clinical and psychological variables upon the oral health-related quality of life in patients with temporomandibular disorders. Med Oral Patol Oral Cir Bucal. 2017;22(6):e669-e678. [PubMed]  [PMC] 
  27. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997;8(3):291-305. [Crossref]  [PubMed] 
  28. Oliveira LK, Almeida Gde A, Lelis ÉR, Tavares M, Fernandes Neto AJ. Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals. Braz Oral Res. 2015;29:S1806-83242015000100265. [Crossref]  [PubMed] 
  29. Rantala MA, Ahlberg J, Suvinen TI, Savolainen A, Könönen M. Chronic myofascial pain, disk displacement with reduction and psychosocial factors in Finnish non-patients. Acta Odontol Scand. 2004;62(6):293-7. [Crossref]  [PubMed] 
  30. Ekici Ö. Relationship between chronic pain and sleep quality in patients with temporomandibular joint dysfunction. J Turkish Sleep Med. 2021;8(1):67-72. [Crossref] 
  31. Kokkola O, Suominen AL, Qvintus V, et al. Efficacy of stabilisation splint treatment on the oral health-related quality of life-A randomised controlled one-year follow-up trial. J Oral Rehabil. 2018;45(5):355-62. [Crossref]  [PubMed] 
  32. Cioffi I, Perrotta S, Ammendola L, Cimino R, Vollaro S, Paduano S, et al. Social impairment of individuals suffering from different types of chronic orofacial pain. Prog Orthod. 2014;15(1):1-5. [Crossref]  [PubMed]  [PMC] 
  33. Castro AR, Siqueira SR, Perissinotti DM, Siqueira JT. Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder. Arq Neuropsiquiatr. 2008;66(3B):716-9. [Crossref]  [PubMed] 
  34. Ekici Ö. Association of stress, anxiety, and depression levels with sleep quality in patients with temporomandibular disorders. Cranio. 2020:1-9. [Crossref]  [PubMed] 
  35. Resende CM, Alves AC, Coelho LT, Alchieri JC, Roncalli AG, Barbosa GA. Quality of life and general health in patients with temporomandibular disorders. Braz Oral Res. 2013;27(2):116-21. [Crossref]  [PubMed] 

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