Correlates Between Temporomandibular Disorder Symptom Severity, Psychological Distress, Well-Being, and Oral Health-Related Quality of Life: Insights From Chinese Young Adults

Background: There is limited understanding of how temporomandibular disorder (TMD) symptoms, psychological distress, and well-being are related to each other and to OHRQoL in Chinese young adults.

Objectives: This study aimed to identify correlations between TMD symptom severity, psychological status, and OHRQoL while also examining factors associated with low OHRQoL.

Methods: Participants, recruited from a major university in the capital city, completed a survey that included demographics, the Chinese versions of the expanded five TMD symptoms (5Ts) screener, Depression, Anxiety, Stress Scales-21 (DASS-21), Ryff's Scales of Psychological Well-being-18 (SPWB-18), and Oral Health Impact Profile for TMDs (OHIP-TMD). Data were analysed using Chi-square and Kruskal-Wallis/Mann-Whitney U tests, Spearman's correlation, and logistic regression (α = 0.05).

Results: The study sample consisted of 414 individuals (mean age 22.0 years [SD 2.1], 77.8% female). Among them, 23.4%, 22.2%, 15.7%, and 38.6% had no (NT), intra-articular (IT), pain-related (PT), and combined (CT) TMD symptoms, respectively. Significant differences were observed in global TMD severity (CT>IT, PT>NT), global distress (CT>IT, NT), and OHRQoL (CT>IT, PT, NT), but not global well-being. Global TMD severity was significantly, albeit weakly, correlated with global distress (r_s = 0.32) and global well-being (r_s = -0.12). Global distress, in turn, showed a significant but weak negative association with global well-being (r_s = -0.34). Both global TMD severity and global distress exhibited moderate correlations with global OHIP (r_s = 0.63/0.42).

Conclusions: Global TMD severity, incorporating symptom duration, frequency, intensity, and interference, was the main determinant of low OHRQoL in Chinese young adults.