Problems of sleep, depression, quality of life in adolescents with TMD diagnosis

Karla Christina Amaral de Pinto Costa1Orcid, Stela Maris Wanderley Rocha2Orcid, Danilo Antonio Duarte3Orcid, Kelly Maria Silva Moreira4Orcid, José Carlos Pettorossi Imparato5Orcid, Victor Cavallaro Bottesini6Orcid, Giselle Rodrigues de Santanna7Orcid

Highlights

Adolescents with TMD are at a greater risk of developing depression and they suffer a greater impact of these on their quality of life.
The quality of life can be affected by an inappropriate level of sleep, which might cause social withdrawal, anxiety and low self-esteem.
More attention should be given to this patient group by preventing and controlling the progression of dysfunction as well as providing more comprehensive treatment and multidisciplinary interaction.

Abstract

Aim: To verify the relationship between temporal-mandibular dysfunction (TMD) with depression, sleep, sleepiness and quality of life in adolescents aged 13 to 18 years old. Methods: Thirty-eight adolescents being seen at the UFAL Dental Clinic (Federal University of Alagoas), for TMD, and qualifying according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD), participated in the study. Two instruments were used to investigate sleep quality: the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS); the Oral Health Impact Profile (OHIP-14) for quality-of-life assessment; and the Beck Depression Inventory (BDI-II) for depression assessment. Pearson’s correlation coefficient was used for the relationship of numerical variables. For the means tests, the Student t test was applied (using, when necessary, the Welch correction). For the analyses, the Bonferroni correction was considered. Results: After calculation, αBonferroni correction was applied equal to 0,0005. Of the total number of participants (56% female and 44% male), with a mean age of 14.7). In all comparisons between groups (with and without TMD), there were statistically significant indices for adolescents with TMD in relation to: depression (p=5.6∙10-11), quality of life (p=4.3∙10-12), sleep quality (p=5.0∙10-10), and somnolence (p=0.0002). From the correlation matrix, it was observed that all correlations were significantly positive and moderate. Conclusions: Adolescents with a diagnosis of TMD presented an increase of depression and somnolence, as well as impairment of sleep quality and quality of life, and these same variables can influence on the onset of TMD.

Keywords: Adulthood; Temporomandibular Dysfunction; Temporomandibular Joint

Author Affiliations

  1. Postgraduate student. Department of Pediatric Dentistry, São Leopoldo Mandic College. Campinas, Brazil
  2. Professor. Department of Stomatology, Federal University of Alagoas. Alagoas. Brazil
  3. Professor. Department of Pediatric Dentistry, São Leopoldo Mandic College. Campinas, Brazil
  4. Postgraduate student. Department of Pediatric Dentistry, State University of Campinas. Piracicaba, Brazil
  5. Professor. Department of Pediatric Dentistry, University of São Paulo. São Paulo, Brazil
  6. Undergraduate student. Department of Pediatric Dentistry, School of Dentistry, APCD. São Paulo, Brazil (✉ Correspondence: victorbottesini@gmail.com)
  7. Professor. Department of Pediatric Dentistry, São Leopoldo Mandic College. Campinas, Brazil
  1. Conti PCR, Fiamengui LMSP, Cunha CO, Conti ACF. Orofacial pain and temporomandibular disorders – the impact on oral health and quality of life. Braz Oral Res 2012;26:120-123
  2. Conti PCR, Bonjardim LR. Temporomandibular Disorder, facial pain and the need for high level information. J Appl Oral Sci 2014;22:1-1
  3. Bertoli FMP, Bruzamolin CD, Pizzatto E, Losso EM, Brancher JA, Souza JE. Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents. Plos One 2018: 8:1-11
  4. Durham J, Newton-John TRO, Zakrzewska JM. Temporomandibular disorders. BMJ 2015;350:1-9
  5. Pereira LJ, Cenci TP, Pereira SM, Cury AADBC, Ambrosano GMB, Pereira AC, Gavião MBD. Psychological factors and the incidence of temporomandibular disorders in early adolescence. Braz Oral Res 2009;23:155-160
  6. Calixtre LB, Gruninger BL, Chaves TC, Oliveira AB. Is there an association between anxiety/ depression and temporomandibular disorders in college students?. J Appl Oral Sci 2014;22:15-21
  7. Lei J, Liu MQ, Yap AUJ, FU KY. Sleep Disturbance and Psychologic Distress: Prevalence and Risk Indicators for Temporomandibular Disorders in a Chinese Population. J Oral Facial Pain Headache 2015;29:24–30
  8. Silva CB, Henn CG, Bonacina CM, Bavaresco CS. Frequency of Temporomandibular Disorders (TMD) and their relationship with anxiety and depression among dental patients of a Health Care Unit. APS 2014;17: 516-522
  9. Dougall AL, Jimenez CA, Haggard RA, Stowell AW, Riggs RR, Gatchel RJ. Biopsychosocial factors associated with the subcategories of acute temporomandibular joint disorders. J Orofac Pain 2012;26:7-16
  10. Sipilä K, Mäki P, Laajala A, Taanila A, Joukamaa M, Veijola J. Association of depressiveness with chronic facial pain: a longitudinal study. Acta Odontol Scand 2012;71:644-649
  11. Hirsch C, Türp JC. Temporomandibular pain and depression in adolescents—a case–control study. Clin Oral Invest 2010;14:145–151
  12. Barbosa TS, Leme MS, Castelo PM, Gavião MB. Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder. Health Qual Life Outcomes. 2011;9:32-35
  13. Barros VM, Seraidarian PI, Côrtes MIS, Paula LV. The Impact of Orofacial Pain on the Quality of Life of Patients with Temporomandibular Disorder. J Orofac Pain 2009;23:28-37
  14. Silvola AS, Tolvanen M, Rusanen J, Sipilä K, Lahti S, Pirttiniemi P. Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion?. Acta Odontol Scand 2016;74:44-50
  15. Harding EC, Franks NP, Wisden W. The Temperature Dependence of Sleep. Front Neurosci 2019;13:1-16
  16. Owens J, Wang G, Lewin D, Skora E, Baylor A. Association Between Short Sleep Duration and Risk Behavior Factors in Middle School Students. Sleep 2017;40:1-10
  17. Slater G, Steier J. Excessive daytime sleepiness in sleep disorders. J Thorac Dis 2012;4:608–616
  18. Duarte J, Nelas P, Chaves C, Ferreira M, Coutinho E, Cunha M. Sleep-wake patterns and their influence on school performance in Portuguese adolescents. Aten Primaria 2014;46:160-164
  19. Schuh-Hofer S, Wodarski R, Pfau DB, et al. One night of total sleep deprivation promotes a state of generalized hyperalgesia: A surrogate pain model to study the relationship of insomnia and pain. Pain 2013;154:1613–1621
  20. Heredia FP, Garaulet M, Gomez-Martinez S, et al. Selfreported sleep duration, white blood cell counts and cytokine profiles in European adolescents: the HELENA study. Sleep Med 2014;15:251–1258
  21. Drabovicz PVSM, Salles V, Drabovicz PEM, Fontes MJF. Assessment of sleep quality in adolescentes with temporomandibular disorders. J Pediatr Rio J 2012;88:169-172
  22. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorder: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6:301-355.
  23. Pereira FJ, Favilla E, Dworkin S, Huggins K. Critérios de diagnóstico para pesquisa das disfunções temporomandibulares (RDC/TMD). Tradução oficial para a língua portuguesa. J Bras Clin Odontol Integr 2004;8:384-395
  24. Bertolazi AN, Fagondes SC, Hoff LS, Dartora EG, Miozzo CIS, Barba MEF, Barret SSM. Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Medicine 2011;12:70–75
  25. Jonh MW. Reability and fator analyses of the Epworth Sleepness Scale. Sleep 1992; 15:376-381
  26. Bertolazi AN, Fagondes SC, Hoff LS., Pedro VDP, Barreto SSM, Johns MW. Validação da escala de sonolência de Epworth em português para uso no Brasil. J Bras Pneumol 2009;35:877-883
  27. Lee EH, Lee SJL, Hwang ST, Hwang HS, Kim JH. Reliability and Validity of the Beck Depression Inventory-II among Korean Adolescents. Psychiatry Investig 2017;14:30-36
  28. Gorenstein C, Andrade L. Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res 1996;29:437-453
  29. Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol 1997;25:284-290
  30. Oliveira BH, Nadanovsky P. Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form. Community Dent Oral Epidemiol 2005;33:307–314
  31. Paduano S, Bucci R., Rongo R, Silva R, Michelotti A. Prevalence of temporomandibular disorders and oral parafunctions in adolescents from public schools in Southern Italy. Cranio 2018:14:1-6
  32. Lee Y, Hong I, An J. Anterior joint space narrowingin patients with temporomandibular disorder. J Orofac Orthop 2019;80:116-127
  33. Xue XT, Zhang T, Cui SJ, He DQ., Wang XD, Yang RL, et al. Sexual dimorphism of estrogen-sensitized synoviocytes contributes to gender difference in temporomandibular joint osteoarthritis. Oral Dis 2018;24:1503-1513
  34. Guideline on Acquired Temporomandibular Disorders in Infants, Children, and Adolescents. Pediatr Dent. 2016;38:308-314
  35. Song YC, Yap AU, Türp JC. Association between temporomandibular disorders and pubertal development: A systematic review. J Oral Rehabil 2018;45:1007–1015
  36. Rehm DDS, Progiante PS, Pattussi MP, Pellizzer EP, Grossi PK, Grossi ML. Depression and Somatization in Patients with Temporomandibular Disorders in a Population-Based Cross-Sectional Study in Southern Brazil. Int J Prosthodont 2019;32:248–250
  37. Pinto RGS, Leite WMA, Sampaio LSS, Sanchez MO. Association between temporomandibular signs and symptoms and depression in undergraduate students: descriptive study. Rev Dor São Paulo 2017;18:217-224
  38. Canales GT, Nardini LG, Barbosa CMR, Conti PCR, Manfredini D. Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. J Appl Oral Sc 2019;27:1-6
  39. Pigozzi LB, Progiante PS, Pattussi MP, Pellizzer EP, Grossi PK, Grossi ML. General Health Quality of Life in Patients with Temporomandibular Disorders in a Population-Based Cross-Sectional Study in Southern Brazil. The International Journal of Prosthodontics 2019;32:237–240
  40. Frid P, Nordal E, Bovis F, Giancane G, Larheim TA. Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis. Arthritis Care Res 2017;69:677–686
  41. Rai B, Kaur J. Association between stress, sleep quality and temporomandibular joint dysfunction: simulated Mars Mission. Oman Med J 2013;28:216–219
  42. Wong MM, Brower KJ. The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health. J Psychiatr Res 2012; 46:953–959
  43. Lei J, Fu J, Yap AU, Fu KY. Temporomandibular disorders symptoms in Asian adolescents and their association with sleep quality and psychological distress. Cranio 2016;34:242-249
  44. Park YM, Lee S., Kim KH, Ahn YW, Jeong SH, Ok SM. The Relationship between Sleep Quality and Clinical Features of Adolescents with Temporomandibular Disorder. J Oral Med Pain 2018;43:27-33
  45. Rener-Sitar, K, Jonh MT, Bandyopadhyoy D, Howell MJ, Schiffman EL. Exploration of dimensionality and psychometric properties of the Pittsburgh Sleep Quality Index in cases with temporomandibular disorders. Health Qual Life Outcomes 2014;12:1-9
  46. Shochat T, Cohen-Zion M, Tzischinsky O. Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Med Rev 2014;18:75–87
  47. Colrain IM, Baker FC. Changes in sleep as a function of adolescent development. Neuropsychol Rev 2011;21:5–21
  48. Gustafsson ML, Laaksonen C, Aromaa M, Asanti,R, Heinonen O, Koski P, Koivusilta L, Leoyttyniemi E, Suominen S, Salanter S. Association between amount of sleep, daytime sleepiness and healthrelated quality of life in schoolchildren. J Adv Nurs 2016:1263-1272
  49. Jariyasakulroj S, Mitrirattanakul S. Excessive daytime sleepiness in temporomandibular disorder patients. Cranio 2020;38:144-148
  50. Amaral MO, Garrido AJ, Pereira C, Master NV, Nunes C, Sakellarides, CT. Quality of life, sleepiness and depressive symptoms in adolescents with insomnia: A cross-sectional study. Elservier 2017;49:35-41
  51. Natu VP, Yap AU, Su MH, Irfan Ali NM, Ansari A. Temporomandibular disorder symptoms and their association with quality of life, emotional states and sleep quality in South-East Asian youths. J Oral Rehabil 2018;45:756-763

Article Info

Contemp Pediatr Dent 2021:2(2):101-112

Received: 29 July 2021

Accepted: : 07 September 2021

Online First: 08 September 2021

DOI: 10.51463/cpd.2021.71

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					Karla Christina Amaral de Pinto Costa, Stela Maris Wanderley Rocha, Danilo Antonio Duarte, Kelly Maria Silva Moreira, José Carlos Pettorossi Imparato, Victor Cavallaro Bottesini, Giselle Rodrigues de Santanna. Problems of sleep, depression, quality of life in adolescents with TMD diagnosis. Contemp Pediatr Dent 2021:2(2):101-112.

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