Prevalence of temporomandibular joint disorders and their association with anxiety and bruxism in dental students and house officers: a cross-sectional study from Punjab, Pakistan

Objective: To identify prevalence of temporomandibular joint disorders (TMD) and their association with anxiety and bruxism in dental students and house officers in Punjab, Pakistan. Methodology: This cross-sectional study was conducted in two private dental institutes of Punjab from February 2022 to March 2023, on BDS students and house officers diagnosed with at least one symptom of TMD after screening. We used Diagnostic Criteria for the Most Common Intra-Articular Temporomandibular Disorders self-administered questionnaire and Patient Health Questionnaire (PHQ-4). Results: Out 433 participants, 141 (32.5%) had TMD pain; more than half were females, and around one-third were house officers (n=50, 35.5%). The mean PHQ score was 5.11 +/- 2.46, falling in the moderate anxiety range. Female patients (p=0.026), bruxers (p=0.023), those with myofascial pain (p=0.034), headaches (p=0.001), and referred myofascial pain (p=0.025) had significantly higher mean PHQ scores. The top three findings were disc displacement with reduction (n=16, 47%), headache (n=12, 35.2%) and local myalgia (n=12, 35.2%). A significantly higher proportion of females with TMD reported local myalgia (p=0.045), and a significant proportion of respondents with TMD and bruxism reported local myalgia (p=0.002). Conclusion: The anxiety levels, as well as myofascial pain, among the female respondents and bruxers suffering from TMDs were significantly higher. Myofascial discomfort, headaches, and disc displacement with reduction were the most common symptoms. The results highlight the significance of mental health education, routine evaluations, and therapies for dental students with TMDs.