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Association between anterior tooth wear and temporomandibular disorder pain in a German population.

Schierz O, John MT, Schroeder E, Lobbezoo F

Department of Prosthetic Dentistry and Materials Science, University of Leipzig, Germany. oliver.schierz@medizin.uni-leipzig.de

STATEMENT OF PROBLEM: Bruxism is purported to be a risk factor for temporomandibular disorder (TMD) pain, but the association requires clarification. PURPOSE: The purpose of this study was to investigate the relation between anterior tooth wear as an indicator for bruxism and the presence of TMD pain. MATERIAL AND METHODS: Study subjects included 646 participants (age range 35 to 44 years) of a national oral health survey in Germany. Anterior tooth wear was registered for each anterior tooth with a 4-point scale (none, mild, moderate, and severe wear). Temporomandibular disorder was defined as self-reported pain in the face, jaw muscles, and/or temporomandibular joint (TMJ) during the last month, according to either the German version of the Research Diagnostic Criteria for Temporomandibular Disorders or the response to a question about pain in the masticatory muscles or the TMJ according to the Helkimo-Index. A multiple logistic regression analysis, controlling for the effects of age and gender, investigated the linear relationship between increased tooth wear and the risk of TMD pain. RESULTS: After adjusting for age and gender, an odds ratio of 1.11 (95% confidence interval: 0.7-1.8) indicated that the risk of TMD pain increased an estimated 11% per unit increase of tooth wear. There was no statistically significant or clinically relevant relationship between a linear increase of tooth wear and risk of TMD pain. CONCLUSION: Anterior tooth wear was not associated with self-reported TMD pain in 35- to 44-year-old subjects. Using anterior tooth wear as an indicator for long-term bruxing behavior, a clinically relevant dose-response relationship between this type of bruxism and TMD pain does not appear to exist.

Published 5 June 2007 in J Prosthet Dent, 97(5): 305-9.
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