Predictors for the development of temporomandibular disorders in scuba divers

The aim was to determine predictors for the development of complaints of temporomandibular disorders (TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five-hundred and thirty-six scuba divers (mean ± SD age = 40·4 ± 11·9 years; 34·1% women) completed a specifically developed questionnaire, either online or on paper. Stepwise forward logistic regression analysis was performed to predict the presence of TMD pain, with several potential risk factors as predictors. Four hundred and eighty-five of the 536 respondents were free of any TMD pain before they started diving actively. In this sample, TMD pain was present in 214 persons (44·1%). Four predictors contributed significantly to the presence of TMD pain, viz., clenching (OR = 2·466), warm water (OR = 1·685), biting on the mouthpiece (OR = 1·598), and the quality rating of the mouthpiece (OR = 0·887, that is, a higher rating means a smaller odds of having TMD pain). TMD pain is a common complaint among scuba divers who were free of such complaints before they started diving actively. Clenching, biting on the mouthpiece, and a low rating of the mouthpiece are predictors for the presence of TMD pain in scuba divers, while diving in cold water serves as a protective factor for TMD pain.