Economic inequalities and temporomandibular disorders: A systematic review with meta-analysis

IntroductionTemporomandibular disorders (TMDs) are a common and debilitating condition that affects millions of people globally. Despite extensive research on TMDs, the exact causes of these conditions remain unclear. However, various factors, including genetics, injury and stress, have been implicated in their development. In addition to these traditional risk factors, the literature suggests that socioeconomic status (SES) may also play a role in the development and progression of TMDs. By synthesizing the available evidence, this review will provide a comprehensive understanding of the role of SES in TMDs and will inform the development of targeted interventions to reduce the burden of these disorders among individuals with lower SES. MethodsWe conducted this systematic review followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020. PubMed, Scopus and Lilacs were searched using the terms: ((socio-economic status OR economic status) AND (temporomandibular disorders OR temporomandibular joint) from the inception until February 10, 2023. We applied the following questions: (P) Participants consisted of human subjects. (E) The Exposure consisted of low economic stats. (C) The Comparison: subjects reporting low economic status were compared to subjects reporting medium-high economic status. (O) The Outcome consisted of TMDs diagnosis. Review Manager version 5.2.8 (Cochrane Collaboration; 2014) software was applied to perform the pooled analysis. ResultsThe included subjects in this review were 14 607. Among them, 631 reported a low economic income, 1880 a medium-high economic income, 4617 were blue-collar workers and 7478 were white-collar workers or entrepreneurs. Among those reporting a low economic income or belonging to the blue-collar workers 12.93% (679/5248) presented sign/symptoms of TMD or a diagnosis of TMD whereas 10.6% (997/9358) of those with a high economic income/white-collar worker. ConclusionWe observed a slightly higher prevalence of TMD among individuals with a low economic income Further research is needed to better understand this relationship and to develop effective interventions to reduce the burden of TMD among individuals with low income.