Presence of TMD-related pain and symptoms associated with anxiety in Peruvian students in their final years of dental education: an analytical cross-sectional study under a multivariable regression model.

Abstract

Background: Temporomandibular disorders (TMD) are frequently associated with anxiety, as this can increase the hyperactivity of the masticatory muscles, resulting in TMD-related pain and symptoms. The aim of this study was to assess the presence of TMD-related pain and symptoms associated with anxiety levels in Peruvian students in their final years of dental education.

Methods: This analytical cross-sectional study of 273 Peruvian students in the final two years of dental education was conducted from October to December 2023. The Zung test was employed to diagnose anxiety, while the TMD-Pain Screener questionnaire was utilized to diagnose painful temporomandibular disorders (TMD). A Poisson regression model with robust variance using Adjusted Prevalence Ratio (APR) was employed to assess the prevalence of TMD-related pain and symptoms. The following variables were considered in the analysis: anxiety, sex, age, academic year, marital status, area of residence, type of housing, living with parents, and occupation. All statistical tests were conducted with a significance level of p < 0.05.

Results: The prevalence of TMD-related pain and symptoms was 24.5%. The 0.7% of the sample exhibited very extreme levels of anxiety; 8.1% demonstrated severe anxiety; and 39.9% exhibited mild to moderate anxiety. Furthermore, dental students with severe to very extreme anxiety and with mild to moderate anxiety were 8.2 times and 3.8 times, respectively, more likely to present TMD-related pain and symptoms (APR = 8.18, 95% CI: 4.62-14.47 and APR = 3.84, 95% CI: 2.18-6.75, respectively), compared to those who did not have anxiety. Conversely, no significant association was observed between the presence of TMD-related pain and symptoms and sex, age, academic year, marital status, area of residence, type of housing, living with parents, or occupation (p > 0.05).

Conclusion: Almost a quarter of the students in their final years of dental education had TMD-related pain and symptoms. It was found that as the level of anxiety increased, from mild to moderate and from severe to very extreme, the likelihood of experiencing TMD-related pain and symptoms also increased significantly. On the other hand, gender, age, academic year, marital status, area of residence, type of housing, living with parents or occupation were not found to be influential factors in the presence of TMD-related pain and symptoms.