Jeon Hye-Mi, Kim So-Yeun, Ahn Yong-Woo, Ok Soo-Min, Jeong Sung-Hee, Ju Hye-Min
Department of Oral Medicine, Dental Clinic Center, Pusan National University Hospital, Busan, Republic of Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
J Dent Sci. 2025 Jan;20(1):342-349. doi: 10.1016/j.jds.2024.07.001. Epub 2024 Jul 6.
BACKGROUND/PURPOSE: Chewing difficulty can contribute to psychological stress, which reduces the quality of life for older adults. The purpose of this study was to investigate and analyze the severity of masticatory discomfort, stress response, and sleep disturbance in older patients experiencing masticatory discomfort due to tooth loss or temporomandibular disorders (TMD), to find the further treatment direction for these patients.
A total of 392 patients aged 50 years and older with mastication difficulties were analyzed. Two group of patients, those seeking prosthetic treatment due to tooth loss (n = 193) and those who were referred due to TMD-related pain discomfort (n = 199), were identified. Numeric rating scale (NRS), stress response inventory (SRI), and insomnia severity index (ISI) were used as tools to measure patients' subjective chewing discomfort, stress response, and sleep status.
Chewing discomfort and age were found to be much higher in the prosthetic group than in the TMD group. The TMD group had significantly higher scores in five SRI parameters (tension, anger, depression, fatigue, and frustration) as well as total score and a higher percentage of clinical insomnia compared to prosthetic patients.
Since the number of remaining teeth has a significant impact on the masticatory discomfort severity, restoring the occlusion through prosthodontic treatment is important to improve masticatory function. In patients with TMD, it is necessary to assess stress response and sleep quality, and a multidisciplinary treatment approach may be necessary to effectively address masticatory discomfort.
背景/目的:咀嚼困难会导致心理压力,进而降低老年人的生活质量。本研究旨在调查和分析因牙齿缺失或颞下颌关节紊乱病(TMD)而出现咀嚼不适的老年患者的咀嚼不适严重程度、应激反应和睡眠障碍,以找到这些患者的进一步治疗方向。
共分析了392例年龄在50岁及以上有咀嚼困难的患者。确定了两组患者,一组是因牙齿缺失寻求修复治疗的患者(n = 193),另一组是因TMD相关疼痛不适而转诊的患者(n = 199)。使用数字评定量表(NRS)、应激反应量表(SRI)和失眠严重程度指数(ISI)作为工具来测量患者的主观咀嚼不适、应激反应和睡眠状况。
发现修复组的咀嚼不适和年龄远高于TMD组。与修复患者相比,TMD组在SRI的五个参数(紧张、愤怒、抑郁、疲劳和沮丧)以及总分方面得分显著更高,临床失眠的百分比也更高。
由于剩余牙齿数量对咀嚼不适严重程度有显著影响,通过修复治疗恢复咬合对改善咀嚼功能很重要。对于TMD患者,有必要评估应激反应和睡眠质量,可能需要采用多学科治疗方法来有效解决咀嚼不适问题。