Impact of chronic orofacial pain of temporomandibular disorder and anxiety on the academic performance of dental students
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Abstract
Introduction: The presence of chronic pain and mood disorders can be related to the performance of intellectual and technical tasks. Objective: This study evaluated the correlation between anxiety level, chronic orofacial pain of temporomandibular disorders (TMD), and academic performance in dental students. Methods: One hundred ninety-five students (74 men and 121 women) answered the Spielberger’s trait–state anxiety inventory to evaluate the level of anxiety; the Research Diagnostic Criteria for TMD (RDC/TMD) was used to analyze chronic orofacial pain of TMD, and the academic performance was evaluated through the average grade of all college subjects concluded by the students. Correlations between the presence of chronic orofacial pain of TMD, trait, and state anxiety levels, chronic pain grade (CPG), chronic pain intensity (CPI), and academic performance were tested using Pearson's correlation test. Results: The mean age of the students was 21.8 years (SD=2.3). Chronic TMD was observed in 37.5% of the students. The majority of students had moderate trait and state anxiety. A significant correlation was observed between trait-anxiety level and CPG (r=0.148, p=0.044), and CPI (r=0.187, p=0.009). No significant correlation was found between academic grade and presence of chronic pain of TMD (r=0.041, p=0.571), trait (r=0.079, p=0.273) and state-anxiety (r=0.107, p=0.136). Conclusion: The CPG and CPI increase in participants with higher trait-anxiety levels, however, no significant correlation was found between academic performance and trait/state anxiety or chronic orofacial pain of TMD.
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Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet J, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6-27. https://doi.org/10.11607/jop.1151
List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017;37(7):692-704. https://doi.org/10.1177/0333102416686302
Cao Y, Yap AU, Lei J, Zhang M, Fu K. Subtypes of acute and chronic temporomandibular disorders: their relation to psychological and sleep impairments. Oral Dis. 2021;27(6):1498-506. https://doi.org/10.1111/odi.13692
Resende CMBM, Rocha LGDS, Paiva RP, Cavalcanti CS, Almeida EO, Roncalli AG, et al. Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020;129(2):125-32. https://doi.org/10.1016/j.oooo.2019.10.007
Bäck K, Hakeberg M, Wide U, Hange D, Dahlström L. Orofacial pain and its relationship with oral health-related quality of life and psychological distress in middle-aged women. Acta Odontol Scand. 2020;78(1):74-80. https://doi.org/10.1080/00016357.2019.1661512
Trize DM, Calabria MP, Franzolin SOB, Cunha CO, Marta SN. Is quality of life affected by temporomandibular disorders? Einstein (São Paulo). 2018;16(4):eAO4339. https://doi.org/10.31744/einstein_journal/2018AO4339
Minghelli B, Morgado M, Caro T. Association of temporomandibular disorder symptoms with anxiety and depression in Portuguese college students. J Oral Sci. 2014;56(2):127-33. https://doi.org/10.2334/josnusd.56.127
Fernandes G, Goncalves DAG, Siqueira JTT, Camparis CM. Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated. Arq Neuropsiquiatr. 2013;71(12):943-7. https://doi.org/10.1590/0004-282X20130191
Pedroni CR, Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporomandibular disorders in university students. J Oral Rehabil. 2003;30(3):283-9. https://doi.org/10.1046/j.1365-2842.2003.01010.x
Shiau YY, Chang C. An epidemiological study of temporomandibular disorders in university students of Taiwan. Community Dent Oral Epidemiol. 1992;20(1):43-7. https://doi.org/10.1111/j.1600-0528.1992.tb00672.x
Fillingim RB, Ohrbach R, Greenspan JD, Knott C, Diatchenko L, Dubner R, et al. Psychological factors associated with development of TMD: the OPPERA prospective cohort study. J Pain. 2013;14(12 Suppl):T75-90. https://doi.org/10.1016/j.jpain.2013.06.009
Calixtre LB, Gruninger BLS, Chaves TC, Oliveira AB. Is there an association between anxiety/depression and temporomandibular disorders in college students? J Appl Oral Sci. 2014;22(1):15-21. https://doi.org/10.1590/1678-775720130054
Bertoli FMP, Bruzamolin CD, Kranz GOA, Losso EM, Brancher JA, Souza JF. Anxiety and malocclusion are associated with temporomandibular disorders in adolescents diagnosed by RDC/TMD. A cross-sectional study. J Oral Rehabil. 2018;45(10):747-55. https://doi.org/10.1111/joor.12684
Sójka A, Stelcer B, Roy M, Mojs E, Pryliński M. Is there a relationship between psychological factors and TMD? Brain Behav. 2019;9(9): e01360. https://doi.org/10.1002/brb3.1360
Bonjardim LR, Gavião MBD, Pereira LJ, Castelo PM. Anxiety and depression in adolescents and their relationship with signs and symptoms of temporomandibular disorders. Int J Prosthodont. 2005;18(4):347-52.
Giannakopoulos NN, Keller L, Rammelsberg P, Kronmüller KT, Schmitter M. Anxiety and depression in patients with chronic temporomandibular pain and in controls. J Dent. 2010;38(5):369-76. https://doi.org/10.1016/j.jdent.2010.01.003
Khesht-Masjedi MF, Shokrgozar S, Abdollahi E, Habibi B, Asghari T, Ofoghi RS, et al. The relationship between gender, age, anxiety, depression, and academic achievement among teenagers. J Family Med Prim Care. 2019;8(3):799-8-4. https://doi.org/10.4103/jfmpc.jfmpc_103_18
Ruz MEA, Al-Akash HY, Jarrah S. Persistent (anxiety and depression) affected academic achievement and absenteeism in nursing students. Open Nurs J. 2018;12(1):171-9. https://doi.org/10.2174/1874434601812010171
Boscato N, Almeida RC, Koller CD, Presta AA, Goettems ML. Influence of anxiety on temporomandibular disorders - an epidemiological survey with elders and adults in Southern Brazil. J Oral Rehabil. 2013;40(9):643-9. https://doi.org/10.1111/joor.12076
Gaudry E, Spielberger CD. Anxiety and intelligence in paired-associate learning. J Educ Psychol. 1970;61(5):386-91. https://doi.org/10.1037/h0029796
Rocha COM, Peixoto RF, Resende CMBM, Alves ACM, Oliveira AGR, Barbosa GAS. Psychosocial aspects and temporomandibular disorders in dental students. Quintessence Int. 2017;48(3):241-9. https://doi.org/10.3290/j.qi.a37128
Eaves ER, Nichter M, Ritenbaugh C, Sutherland E, Dworkin SF. Works of Illness and the Challenges of Social Risk and the Specter of Pain in the Lived Experience of TMD. Med Anthropol Q. 2015;29(2):157-77. https://doi.org/10.1111/maq.12146
Pesqueira AA, Zuim PRJ, Monteiro DR, Ribeiro PP, Garcia AR. Relationship between psychological factors and symptoms of TMD in university undergraduate students. Acta Odontol Latinoam. 2010;23(3):182-7.
Franco-Micheloni AL, Fernandes G, Gonçalves DAG, Camparis CM. Temporomandibular disorders among Brazilian adolescents: reliability and validity of a screening questionnaire. J Appl Oral Sci. 2014;22(4):314-22. https://doi.org/10.1590/1678-775720130694
Lövgren A, Österlund C, Ilgunas A, Lampa E, Hellström F. A high prevalence of TMD is related to somatic awareness and pain intensity among healthy dental students. Acta Odontol Scand. 2018;76(6):387-93. https://doi.org/10.1080/00016357.2018.1440322
Ferreira CLP, Silva MAMR, Felício CM. Sinais e sintomas de desordem temporomandibular em mulheres e homens. CoDAS. 2016;28(1):17-21. https://doi.org/10.1590/2317-1782/20162014218
Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354-73. https://doi.org/10.1097/00001888-200604000-00009
Roh MS, Jeon HJ, Kim H, Han SK, Hahm BJ. The Prevalence and Impact of Depression Among Medical Students: A Nationwide Cross-Sectional Study in South Korea. Acad Med. 2010;85(8):1384-90. https://doi.org/10.1097/ACM.0b013e3181df5e43
Alzahem AM, van der Molen HT, Alaujan AH, Schmidt HG, Zamakhshary MH. Stress amongst dental students: A systematic review. Eur J Dent Educ. 2011;15(1):8-18. https://doi.org/10.1111/j.1600-0579.2010.00640.x
Aboalshamat K, Hou XY, Strodl E. Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study. Med Teach. 2015;37(1): S75-81. https://doi.org/10.3109/0142159X.2015.1006612
Marbach JJ, Lund P. Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes. Pain. 1981;11(1):73-84. https://doi.org/10.1016/0304-3959(81)90140-8
Monteiro DR, Zuim PRJ, Pesqueira AA, Ribeiro PP, Garcia AR. Relationship between anxiety and chronic orofacial pain of temporomandibular disorder in a group of university students. J Prosthodont Res. 2011;55(3):154-8. https://doi.org/10.1016/j.jpor.2010.11.001
Heer EW, Gerrits MMJG, Beekman ATF, Dekker J, van Marwijk HMJ, Waal MWM, et al. The association of depression and anxiety with pain: a study from NESDA. PLoS One. 2014;15;9(10):e106907. https://doi.org/10.1371/journal.pone.0106907
Bonjardim LR, Lopes-Filho RJ, Amado G, Albuquerque Jr RLV, Goncalves SRJ. Association between symptoms of temporomandibular disorders and gender, morphological occlusion, and psychological factors in a group of university students. Indian J Dent Res. 2009;20(2):190-4. https://doi.org/10.4103/0970-9290.52901
Mazza S, Frot M, Rey AE. A comprehensive literature review of chronic pain and memory. Prog Neuropsychopharmacol Biol Psychiatry. 2018;87(Pt B):183-92. https://doi.org/10.1016/j.pnpbp.2017.08.006
Shaefer JR, Holland N, Whelan JS, Velly AM. Pain and temporomandibular disorders. A pharmaco-gender dilemma. Dent Clin North Am. 2013;57(2):233-62. https://doi.org/10.1016/j.cden.2013.02.005
Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: a cross-sectional study at a College of Medicine in Saudi Arabia. J Heal Popul Nutr. 2011;29(5):516-22. https://doi.org/10.3329/jhpn.v29i5.8906
Ferrando M, Andreu Y, Galdón MJ, Durá E, Poveda R, Vincente Bagán JV. Psychological variables and temporomandibular disorders: Distress, coping, and personality. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(2):153-60. https://doi.org/10.1016/j.tripleo.2003.12.030
Ramalho D, Macedo L, Goffredo Filho G, Goes C, Tesch R. Correlation between the levels of non-specific physical symptoms and pressure pain thresholds measured by algometry in patients with temporomandibular disorders. J Oral Rehabil. 2015;42(2):120-6. https://doi.org/10.1111/joor.12236