The Role of Gender in Temporomandibular Disorders Subtypes: A Cross-Sectional Study in A Southern Brazilian Population.

Abstract

Objectives: To assess prevalence and the role of sex as a risk indicator for the development of temporomandibular disorders (TMD) subtypes. This population-based cross-sectional study randomly sampled subjects attending the public health system in the city of Maringá, Brazil. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I was used to classify TMD subtypes; and the RDC/TMD Axis II, to assess Graded Chronic Pain Scale (GCPS), depression, somatization with or without pain, sociodemographic data, oral and general health, and pain history. Sleep quality was assessed by the Sleep Assessment Questionnaire (SAQ®).

Results: TMD in the selected sample (n=1,643, 65.85% women) was significantly more prevalent in women as compared to men: a) GCPS moderately/severely limiting (6.3% versus 2.9%), b) muscle diagnoses (34.0% versus 20.7%), c) and disc displacements (9.0 versus 5.2). Psychological related disorders were also significantly more prevalent in women: a) depression (53.0% versus 33.5%), b) somatization without pain (48.5% versus 32.8%), and c) somatization with pain (55.5% versus 34.4%), but not significant for sleep quality (56.0% versus 58.6%). TMD pain was predominantly chronic, recurrent, and significantly higher in women than men (78.2% versus 67.6%, <0.01). Female sex significantly increased the risk (adjusted odds ratio) of developing TMD in 70% for moderately and severely limiting GCPS, 50% for developing TMD muscle diagnoses, and 70% for disc displacements, even after controlling for psychological and sociodemographic related variables.

Conclusions: Sex do play a role in the development of TMD subtypes (muscle diagnoses and disc displacements) and chronicity.