Physical, psychological and socio-demographic predictors related to patients’ self-belief of their temporomandibular disorders’ aetiology

Background: The aetiology of temporomandibular disorders (TMDs) has been widely discussed in literature, but little is known about patients’ self-belief of their TMD aetiology.

Objective: For six categories of self-believed aetiology of the TMD complaint (viz., occlusal factors, physical trauma, emotional stress, deep pain input, parafunctions and unknown), associations with physical, psychological and socio-demographic predictors were assessed.

Methods: In this retrospective study, medical records of 328 TMD patients who had visited a clinic for Orofacial Pain and Dental Sleep Medicine were analysed. Results: The most frequently reported self-believed TMD aetiology was ‘unknown’ (42.3%). The category ‘occlusal factors’ was associated with pain worsening with emotion. ‘Physical trauma’ as self-believed aetiology was associated with TMD dysfunction score. ‘Emotional stress’ was associated with awake bruxism and age 18-49 years. ‘Deep pain input’ was associated with TMD dysfunction score, sleep bruxism, and arthritis or joint pain. ‘Parafunctions’ were associated with sleep bruxism. ‘Unknown’ was associated with TMD symptoms severity and work disability.

Conclusion: For each category of self-believed aetiology of the TMD complaint, different associations with physical, psychological and socio-demographic predictors were identified. This may suggest that individual phenotypes play a role in the patient's belief in the cause of the TMD complaint. Determination of phenotypic risk factors associated with aetiological self-belief might help clinicians to provide better treatment, including counselling, to their patients.