Mental Well-Being Is Associated With Temporomandibular Disorder Pain Onset and Remission

J Oral Rehabil. 2026 Jun 18. doi: 10.1111/joor.70236. Online ahead of print.

ABSTRACT

BACKGROUND: Temporomandibular disorders (TMD) impact the everyday lives of those affected. However, the longitudinal role of sick leave and health-related quality of life (HRQoL) in TMD-pain onset and remission is largely unknown.

OBJECTIVES: To explore whether TMD-pain onset and remission are associated with HRQoL and sick-leave history.

METHODS: The cohort comprised 33 571 individuals, aged 23-74 years, who participated in a community intervention programme and had routine dental check-ups in Västerbotten County, Sweden. HRQoL was assessed using two domains, i.e., Mental Component Summary (mental well-being) and Physical Component Summary (physical well-being), of the Short Form 36 Health Survey Questionnaire. Sick-leave history was defined as self-reported sick leave for at least 6 months. Associations with TMD-pain onset and remission were analysed using Markov multi-state models.

RESULTS: Better mental and physical well-being were associated with lower rates of TMD-pain onset (hazard ratio [HR] per 10-unit increase: 0.84, CI: 0.79-0.89, and 0.90, CI: 0.84-0.96, respectively), whereas sick leave was associated with higher rates (HR: 1.18, CI: 1.03-1.36). Better mental and physical well-being were associated with higher rates of TMD-pain remission (HR per 10-unit increase: 1.33, CI: 1.28-1.37, and 1.68, CI: 1.62-1.75, respectively), whereas sick leave was associated with lower rates (HR: 0.49, CI: 0.46-0.53).

CONCLUSIONS: The associations of sick leave, mental well-being, and physical well-being with TMD-pain remission emphasise the importance of applying a holistic approach to pain assessment and management. In addition, mental well-being is associated with TMD-pain onset, indicating that this could be a factor to consider when designing preventative strategies.

PMID:42316900 | DOI:10.1111/joor.70236