Association of Oral Behaviors with Anxiety, Depression, and Jaw Function in Patients with Temporomandibular Disorders in China: A Cross-Sectional Study.

BACKGROUND The aim of this study was to investigate the association of oral behaviors (OBs) with anxiety, depression, and jaw function in patients with temporomandibular disorders (TMDs) in China. MATERIAL AND METHODS A total of 537 patients diagnosed with TMD were included in this study (average age, 31.55±12.08 years; 86 men [16.0%] and 451 women [84.0%]). There were 31 cases of masticatory muscle pain, 459 cases of disc displacement, and 13 cases of arthralgia/arthrosis, and 34 cases were uncategorized. Patients were assessed using the Oral Behaviors Checklist (OBC), Jaw Functional Limitation Scale (JFLS), Generalized Anxiety Disorder-7 (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9). The relationships between OBC scores and mouth opening, pain scores, JFLS, PHQ-9, and GAD-7 were evaluated with Spearman's correlation analysis. The median TMD symptom duration was 3 (0.5-154) months; men and women did not differ significantly in symptom duration or in the number of episodes of depression and anxiety. RESULTS The following OBs were common in patients with TMDs: "putting pressure on the jaw (52.9%)", "chewing food on 1 side (47.5%)", and "holding teeth together during activities other than eating (33.3%)". The OBC scores were significantly correlated with the JFLS, PHQ-9, and GAD-7 scores (P<0.01). CONCLUSIONS Patients with TMDs exhibit specific OBs, which are associated with depression, anxiety, and jaw function. It is necessary to further investigate the interaction of OBs with depression and anxiety in the development of TMDs.