Prevalence of Oral Parafunctional Habits in Children and Related Factors: An Observational Cross-sectional Study

Causal Relationship Between Autoimmune Arthritis and Temporomandibular Disorders

OBJECTIVE

Accumulating evidence has indicated a close interrelation between autoimmune arthritis (AA) and temporomandibular disorders (TMD), but the causality is still unclear. The study aimed to explore the causal inference between AA and TMD using a bidirectional Mendelian randomization analysis.

METHODS

Online genome-wide association study data on rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis, and TMD were obtained from the FinnGen and IEU databases. Causality was using the inverse variance-weighted method as the primary analysis and supplemented by other methods. Sensitivity analyses, including heterogeneity tests, horizontal pleiotropy tests, and leave-one-out methods, were conducted to investigate the stability and reliability of the results.

RESULTS

The inverse variance-weighted test indicated that several AA types could causally increase the TMD risk, including overall RA (odds ratio [OR] = 1.348, 95% confidence interval [CI] = 1.1232-1.618, P = .001), subtype nRA (OR = 1.118, 95% CI = 1.044-1.197, P = .001), and AS (OR = 1.060, 95% CI = 1.024-1.097, P = .001). Moreover, the causal association of the above combinations has been proven to be stable and reliable using sensitivity and other tests.

CONCLUSION

These findings suggest that RA and AS might be causally associated with an increased risk of TMD. However, more studies are needed to check the causal effects of AA on TMD and analyse the potential mechanisms further.

Comparative study of the profile of supragingival dental plaque and tooth decay in patients with lupus erythematosus and rheumatoid arthritis

BACKGROUND AND OBJECTIVES

Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are complex autoimmune diseases that present with a range of systemic and oral manifestations including dental decay and alterations in the oral microbiome profile. The purpose of this study was to compare the fungal and bacterial profile of supragingival dental plaque and dental caries in patients with SLE and RA.

METHODS

The present descriptive-cross-sectional-analytical study was conducted on 91 participants (31 RA, 30 lupus, and 30 control groups). Decayed, Missing, and Filled teeth (DMFT) and The International Caries Detection Assessment System (ICDAS) indices were used to investigate tooth decay. The DAS-28 index was used to assess the severity of RA, and the SLEDAI-2 K index was used to evaluate the severity of lupus. The number of supragingival dental plaque Streptococcus mutans, Lactobacillus spp. and Candida albicans colonies were evaluated using Mitis Salivarius Agar (MSA), deMan-Rogosa-Sharpe agar (MRS) and Sabouraud Dextrose Agar with Chloramphenicol (SC) culture medium, respectively. Data were analyzed using one-way ANOVA, Kruskal -Wallis, k2, Fisher's tests, and Spearman's correlation coefficient.

RESULTS

A statistically significant relationship was observed between the education level (P = 0.030), mean of DMFT, ICDAS, MSA and SC indices (P < 0.001) with the type of disease. The control and RA group showed significantly higher MRS index than the lupus group (P < 0.001). There was significant and positive correlation between the severity of the disease in lupus patients and SC (Candida albicans) (P < 0.001, R = 0.698) and MRS (P = 0/020, R = 0.408) indices.

CONCLUSION

Dental decay and the fungal and bacterial flora of supragingival dental plaque patients are higher than in the healthy group. It is recommended that these patients pay more attention to their oral hygiene and undergo periodic oral examinations.

Evaluation of laser acupuncture versus physical therapy intervention in management of bruxism in children: a randomized controlled trial

BACKGROUND

Bruxism is a predominant behavior in children and is involved in the development of temporomandibular joint (TMJ) disease and myofacial pain. Bruxism can be classified into; sleep and awake bruxism or primary and secondary bruxism. This habit is characterized by a decrease in mouth opening, pain and increased activity of muscles of mastication and loud sounds during sleep. Management includes sleep hygiene, low-level lasers and physical therapy. The aim of this study was to evaluate changes in pain, mouth opening and muscle activity in children with bruxism after using laser acupuncture versus relaxation physical therapy.

METHODS

Twenty-four children (6-12 years) with a history of bruxism were randomly allocated to 3 groups of 8 individuals each: Group 1: laser acupuncture; Group 2: physical therapy and Group 3: control. At baseline and after 2 months, the visual analog scale (VAS) score for pain (TMJ) score, maximum degree of mouth opening, and maximum voluntary contraction (MVC) score were recorded.

RESULTS

Compared with the control group, the laser and physical therapy groups presented significant differences in pain, maximum number of mouth openings and MVC (p value are 0, 0.005 and 0 respectively).

CONCLUSIONS

Laser acupuncture and physical therapy are promising options for treating SB in children in terms of pain, mouth opening and muscle activity in comparison to sleep hygiene.

TRIAL REGISTRATION

The study was registered on ClinicalTrials.gov on November 12, 2023, with ID: NCT06131879.

The Association Between Specific Oral Behaviors and the Number of Temporomandibular Disorder Symptoms in the General Population: A Cross-Sectional Study

OBJECTIVE

This study aimed to thoroughly explore the relationship between individual oral behavior and the differing numbers of temporomandibular disorder (TMD) symptom in the general population.

METHODS

A total of 565 participants were recruited and completed a questionnaire containing demographic characteristics, eight specific oral behaviors, and five major TMD symptoms (5Ts) checklist. Multivariate linear regression analysis was performed to assess the relationship between individual oral behavior and the number of TMD symptoms, after controlling for confounders.

RESULTS

The prevalence of TMD symptoms was up to 38.2% in the general population, with 64.6% of the participants engaging in one or more oral behaviors. Female participants showed a stronger positive association with most oral behaviors than males. Moreover, wake oral behaviors exhibited a higher correlation coefficient value with TMD symptom number than sleep oral behaviors. Among the eight oral behaviors, bruxism in sleep exhibited no significant correlation with the of TMD symptom number (P>0.05). Seven other specific oral behaviors were significantly correlated with the number of TMD symptoms by multivariate linear regression analysis (P<0.01). The associations between the seven oral behaviors and TMD symptom number remained significant in sleep posture pressuring jaw (β: 0.165, 95% CI: 0.080-0.250), bruxism in awake (β: 0.341, 95% CI: 0.132-0.550), teeth clenching (β: 0.422, 95% CI: 0.264-0.580), pressing, holding, or touching teeth together (β: 0.282, 95% CI: 0.169-0.395), holding or tightening muscles without clenching (β: 0.447, 95% CI0.304-0.589), holding jaw forward or to the side (β: 0.694, 95% CI0.526-0.861), and holding jaw in rigid or tense position (β: 0.571, 95% CI0.418, 0.724) after adjustment for demographic factors (P<0.01).

CONCLUSION

There was a positive association between seven specific oral behaviors and TMD symptom number. Individuals with higher frequency of specific oral behaviors are more likely to suffer from more TMD symptoms. Sleep bruxism exhibited no association with TMD symptoms and symptom number.

Oral habits among preschool Indian children at Durg-Bhilai city

One of the major contributing causes to the development of malocclusion and other negative impacts on orofacial complexes is oral habits during and after preschool. Therefore, it is of interest to ascertain the prevalence of oral habits in preschoolers in Durg-Bhilai, Chhattisgarh, India. Using the cluster sampling technique, four schools two from each of Durg and Bhilai City were chosen to participate in the study. 400 LKG and UKG students, along with their mothers or caregivers, were chosen based on the inclusion/exclusion criteria. The Chi-square test was employed in the statistical study. Thus, preschoolers at durg-bhilai city, Chhattisgarh, India, had a high prevalence of oral habits.

Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population

BACKGROUND

Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse.

OBJECTIVE

This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population.

METHODS

A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history.

RESULTS

A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P<0.01). The behaviors most strongly associated with PT were "Hold or jut jaw forward/to the side" (OR:4.478), "Hold, tighten or tense muscles without clench" (OR:3.343) and "Hold jaw in rigid or tense position" (OR:3.209).

CONCLUSION

The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.

Temporomandibular Joint Minimally Invasive Procedures in the Pediatric Population: A Prospective Study

Over recent years, temporomandibular joint (TMJ) minimally invasive procedures, such as arthrocentesis and arthroscopy, have been appointed as an initial TMJ intra-articular treatment. Both procedures present safe and effective clinical results in managing temporomandibular disorders (TMD) by reducing pain and improving mouth opening. The use of these techniques in adults is validated in the literature. However, data on the safety and effectiveness of minimally invasive TMJ interventions in pediatric patients are scarce. This study aims to investigate the effectiveness of TMJ arthrocentesis and arthroscopy in the pediatric population. A prospective study was conducted at Instituto Português da Face (IPF) in Lisbon, Portugal, including patients treated for TMD from 1 June 2019 to 30 June 2023. In the present study, 26 patients (17 female and 9 male) were included, representing a total of 48 joints operated. A statistically significant reduction was observed in the primary outcome, TMJ pain, from 3.93 ± 2.80 preoperatively (mean ± SD) to 0.50 ± 1.53 (mean ± SD) postoperatively (p < 0.05). An improvement in the secondary outcome, maximum mouth opening, from 36.92 ± 8.79 preoperatively to 42.96 ± 5.07 postoperatively, was observed (p < 0.05). The overall success rate was 84.62%. This prospective study showed that TMJ arthrocentesis and arthroscopy appear to benefit pediatric patients with TMD, significantly lowering pain and improving MMO without relevant postoperative complications.