title: The association of smoking status with sleep disturbance, psychological functioning, and pain severity in patients with temporomandibular disorders.
abstract: OBJECTIVE
  To evaluate the impact of smoking on pain severity, psychosocial impairment, depression, anxiety, and sleep disturbances in a large sample of patients with temporomandibular disorders (TMD).
  
  
  METHODS
  A retrospective database review was performed on data from 3,251 patients with TMD, diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Pain severity ratings and psychometric data regarding impairment, sleep disturbance, depression, and anxiety were obtained. Differences between smokers and nonsmokers were evaluated by means of chi-square tests and independent samples t tests. Logistic regression models were used to study the impact of smoking, pain severity, and psychometric variables.
  
  
  RESULTS
  Of the total population, 42.5% comprised RDC/TMD group I (muscle pain), 25.3% comprised RDC/TMD group III (joint pain), and 32.2% comprised a mixed RDC/TMD group consisting of patients with both a group I and a group III diagnosis. Of the entire population, 26.9% admitted they were smokers. Even after controlling for relevant covariates, smokers reported significantly higher pain severity, impairment, anxiety, depression, and sleep disturbances than nonsmokers.
  
  
  CONCLUSIONS
  Smokers with TMD reported higher pain severity than nonsmokers with TMD. These patients are at higher risk for factors that may adversely affect treatment outcomes. J OROFAC PAIN 2013;27:32-41.
authors: University of Kentucky, Lexington, KY, USA. rdele0@uky.edu
authors: Reny
authors: R
authors: de Leeuw
authors: Tory
authors: T
authors: Eisenlohr-Moul
authors: Peter
authors: P
authors: Bertrand
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D018771:Arthralgia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004243:Divorce / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007389:Internal-External Control; D004204:Joint Dislocations / Q000453:epidemiology; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D017533:Marital Status; D010003:Osteoarthritis / Q000453:epidemiology; D010147:Pain Measurement / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012847:Single Person / Q000706:statistics & numerical data; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology*; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000145:classification / Q000453:epidemiology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000453:epidemiology