Association between Temporomandibular Disorders Pain, Oral Behaviors, Anxiety and Stress

University of Minnesota M.S. thesis. March 2019. Major: Dentistry. Advisor: Eric Schiffman. 1 computer file (PDF); vii, 30 pages.Aims: Oral behaviors, anxiety and stress are believed to be related to temporomandibular disorders (TMD) pain. The aims of the study were to investigate the association of TMD pain intensity with oral behaviors, anxiety and stress, and the association of oral behaviors with anxiety and stress. Methods: From among the clinical and community-based participants in the multi-site Validation Project, 721 subjects were included in this study who had completed self-report questionnaires that reported pain intensity (Characteristic Pain Intensity [CPI]), oral behaviors (Oral Behavior Checklist [OBC]), anxiety (Symptom Checklist - 90 revised [SCL-ANX]) and stress (Perceived Stress Scale [PSS]) experienced during the previous month; and anxiety experienced during the previous week. Participants were divided into four groups based on the CPI report: no pain, mild, moderate and severe pain, and were compared using analysis of variance (ANOVA). Statistical differences between groups were evaluated using an F-test for continuous variables and Chi-square test for categorical variables. Spearman correlation coefficients were computed to examine the association of (1) CPI with OBC, SCL-ANX and PSS and (2) OBC with SCL-ANX and PSS. Simple linear regression analysis was used to investigate the bivariate relationships for outcomes CPI and OBC. The multivariate regression analysis with age and sex adjustment was conducted to examine relationship between CPI and dependent variables, and OBC and dependent variables. Results: Using CPI as a categorical variable, pain intensity was associated by a dose-response curve relationship for each of the independent variables: OBC, SCL-ANX, and PSS (ANOVA; p<0.0001). Positive correlations were found between CPI versus OBC (r=0.44, n=721), SCL-ANX (r=0.30, n=720), and PSS (r=0.21, n=721) with p<0.0001 for all correlations. Positive correlations between OBC with SCL-ANX (r=0.38, n=720) and PSS (r=0.32, n=721) with p