Larkin Nathan, Fricton Vincent, Sangalli Linda, Prodoehl Janey, Fricton James
College of Dental Medicine - Illinois, Midwestern University, Downers Grove, Illinois, USA.
Physical Therapy Program, Midwestern University, Downers Grove, Illinois, USA.
J Dent Educ. 2024 Dec;88(12):1696-1708. doi: 10.1002/jdd.13675. Epub 2024 Jul 31.
Temporomandibular disorders (TMD) affect individuals undergoing increased stress, for example, dental professionals. No study to date has compared dental students and faculty in TMD manifestation. This cross-sectional study compared prevalence, risk factors, and impact on daily activities of self-reported TMD signs/symptoms between dental students and faculty at a predoctoral dental school, and between preclinical (first- to second-year) and clinical (third- to fourth-year) students.
A REDCap survey was sent to dental students and faculty, assessing TMD signs/symptoms (TMD Symptom Questionnaire), pain intensity (Chronic Graded Pain Scale), jaw function (Jaw Function Limitation Scale), parafunctions (Oral Behavioral Checklist), previous TMD treatments, anxiety/depression symptoms (Patient Health Questionnaire), perceived stress (Perceived Stress Scale), and sleep quality (RU-SATED Scale). Outcomes were compared between groups using chi-square and t-tests, adjusting for covariates with analyses of covariance (ANCOVA).
Data derived from N = 145 participants (N = 108 students, N = 37 faculty). Dental students reported significantly higher prevalence (90.1% vs. 75.7%, p = 0.020) and greater number of TMD signs/symptoms (5.3 ± 3.5 vs. 3.0 ± 2.7, p < 0.001) compared to faculty. Students reported significantly more parafunctional activities (p = 0.000), jaw-strain episodes (prolonged mouth opening, p = 0.007), higher stress level (p = 0.008), and lower sleep quality (p = 0.002) than faculty. Difference in number of TMD signs/symptoms was maintained after adjusting for stress, sleep quality, and parafunctional/jaw-strain activities. Clinical students utilized significantly more often evidence-based TMD treatment compared to preclinical students.
High prevalence of self-reported TMD was observed among dental students and faculty, with students reporting higher prevalence and impairment despite working in the same environment. Findings underscore the importance of education on preventive measures early in dental training to address contributing factors and TMD management.
颞下颌关节紊乱病（TMD）会影响压力增加的人群，例如牙科专业人员。迄今为止，尚无研究比较牙科学生和教师的TMD表现。这项横断面研究比较了一所博士前牙科学院中牙科学生和教师之间自我报告的TMD体征/症状的患病率、危险因素以及对日常活动的影响，以及临床前（一至二年级）和临床（三至四年级）学生之间的差异。
向牙科学生和教师发送了一份REDCap调查问卷，评估TMD体征/症状（TMD症状问卷）、疼痛强度（慢性分级疼痛量表）、下颌功能（下颌功能受限量表）、副功能（口腔行为检查表）、既往TMD治疗情况、焦虑/抑郁症状（患者健康问卷）、感知压力（感知压力量表）和睡眠质量（RU-SATED量表）。使用卡方检验和t检验对组间结果进行比较，并通过协方差分析（ANCOVA）对协变量进行调整。
数据来自N = 145名参与者（N = 108名学生，N = 37名教师）。与教师相比，牙科学生报告的患病率显著更高（90.1%对75.7%，p = 0.020），TMD体征/症状的数量更多（5.3±3.5对3.0±2.7，p < 0.001）。学生报告的副功能活动（p = 0.000）、下颌紧张发作（长时间张口，p = 0.007）、压力水平更高（p = 0.008）以及睡眠质量更低（p = 0.002）均显著多于教师。在对压力、睡眠质量以及副功能/下颌紧张活动进行调整后，TMD体征/症状数量的差异依然存在。与临床前学生相比，临床学生更频繁地使用基于证据的TMD治疗方法。
在牙科学生和教师中观察到自我报告的TMD患病率较高，尽管在相同环境中工作，但学生报告的患病率和损伤程度更高。研究结果强调了在牙科培训早期开展预防措施教育以解决促成因素和TMD管理的重要性。
