title: Association between experience of stressful life events and muscle-related temporomandibular disorders in patients seeking free treatment in a dental hospital.
abstract: OBJECTIVE
  Psychological factors are known to play an important role in the etiology and maintenance of temporomandibular disorders. Since there have been very few studies on this issue in Asian countries, the study was aimed to investigate the relationship between various stressful life events and temporomandibular disorders in patients seeking free treatment in a Dental Hospital, Bangladesh.
  
  
  METHODS
  Five hundred and twenty Bangladeshi adults (370 males and 150 females; mean age, 30.9 +/- 8.2 years) participated in this study. The subjects were given a questionnaire to evaluate their stress status in the last 12 months. The Research Diagnostic Criteria for TMD (RDC/TMD) was used as TMD diagnostic system by three standardized examiners. Two hundred and thirty-six patients were RDC/TMD-defined TMD-positive and were subsequently classified into 7 groups: group I, myofacial pain only; group II, disk displacement only; group III, joint pain only; group IV, myofacial pain and disc displacement; group V, myofacial pain and joint pain; group VI, disc displacement and joint pain; and group VII, myofacial pain, disk displacement and joint pain. Two hundred and eighty-four subjects were RDC/TMD-defined TMD-negative subjects (controls). Adjusted odds ratios were calculated by multiple logistic regression analysis.
  
  
  RESULTS
  Logistic regression analysis revealed that patients diagnosed with myofacial pain (group I) and a combination of myofacial and joint pain (group V) had significantly higher levels of financial and job stress than did the controls. Self-health-related stress and stress related to a spouse or deaths of a relative were also identified as predisposing factors for myofacial pain (group I).
  
  
  CONCLUSIONS
  This study suggests that myofacial pain is more common in individuals with various types of psychological stress. When treating patients with facial pain, dentists should consider the possible presence of psychological factors.
authors.affiliation: Department of Preventive Dentistry, Division of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, West 7, North 13, Kita-ku, Sapporo 060-8586 Japan.
authors.forename: R
authors.initials: R
authors.lastname: Akhter
authors.forename: N M
authors.initials: NM
authors.lastname: Hassan
authors.forename: J
authors.initials: J
authors.lastname: Aida
authors.forename: T
authors.initials: T
authors.lastname: Kanehira
authors.forename: K U
authors.initials: KU
authors.lastname: Zaman
authors.forename: Manabu
authors.initials: M
authors.lastname: Morita
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D017281:Cost of Illness; D003729:Dental Care / Q000191:economics / Q000523:psychology*; D003740:Dental Clinics; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000453:epidemiology / Q000523:psychology*