# Awake oral behaviors associated with temporomandibular-related pain symptoms in a non-patient student population—a dual assessment approach

## TL;DR

This study found that certain oral behaviors like teeth grinding and jaw clenching are linked to jaw pain symptoms in students.

## Contribution

The study uniquely combines self-report and real-time smartphone tracking to identify behaviors associated with jaw pain in non-patients.

## Key findings

- Teeth grinding increased odds of TMD-related pain symptoms by 22% via EMA data.
- Teeth clenching, jaw holding/jutting, and grinding were significant predictors via OBC data.
- The OBC model explained more variance (R² = 0.468) compared to EMA (R² = 0.232).

## Abstract

Background: It is unclear which oral behaviors are harmless and which
might become harmful when performed excessively. This study aimed to determine
which awake oral behaviors are associated with Temporomandibular Disorder
(TMD)-related pain symptoms in a non-patient population. Methods:
Subjects’ awake oral behaviors were assessed through: (i) Oral Behavior Checklist
(OBC), a single-point self-report questionnaire that quantifies the frequency of
awake functional and non-functional oral behaviors; and (ii) Ecological Momentary
Assessment (EMA), a designated smartphone application which enabled real-time
repeated data collection of oral behaviors throughout the day, for multiple days.
118 participants (62.7% female) completed both the OBC and EMA assessment modes.
Subjects were allocated into two groups: (i) subjects with TMD-related pain
symptoms (TMDPS, N = 34, 85.29% female); and (ii) subjects without TMD-related
pain symptoms (noTMDPS, N = 84, 53.57% female). Results: TMDPS subjects
performed more awake oral behaviors compared to noTMDPS subjects. EMA behaviors
that showed a significant predictive ability of masticatory muscle pain in
binomial logistic regressions were entered into a multiple logistic regression
model. Results show that teeth grinding increased the odds of subjects belonging
to the TMDPS group by 22%. The final logistic regression demonstrated acceptable
fit (Nagelkerke’s R2 = 0.232). In a multiple regression model
evaluating the predictive ability of OBC behaviors, the final model showed a
Nagelkerke’s R2 of 0.468. In addition to sex, three OBC
behaviors came out as significant predictors in the final model: teeth grinding
increased the odds of subjects belonging to the TMDPS group by 85%; holding or
jutting the jaw increased the odds by 82%, and clenching increased the odds by
67%. Conclusions: Reports of teeth clenching, holding or jutting jaw
forward or to the side, and teeth grinding may be associated with the report of
TMD-related pain symptoms in a non-patient student population.