Association between symptoms of temporomandibular disorders and depression: An epidemiological study of the Northern Finland 1966 Birth Cohort

Facial pain and other symptoms of temporomandibular disorders (TMD) are rat her common in the adult population. According to clinical studies, psycholo gical factors play an important role in the etiology and maintenance of the se symptoms. On the other hand, chronic pain can cause depression. The aim of this study was to evaluate the association between symptoms of TMD and d epression in a large population sample of young adults. The study was a par t of the 31-year follow-up study of the Northern Finland Birth Cohort consi sting of 12,058 live births from the year 1966. Questionnaire information c oncerning TMD symptoms was collected from a subsample of 5,696 subjects. De pression was measured with a question about reported depression (diagnosed by a doctor) and with the Symptom Checklist depression subscale (SCL-25 DS) . Of the TMD symptoms, those related to pain had the most significant relat ions to indicators of depression. In both genders, the proportion of depres sion indicated with the SCL-25 DS was significantly higher in subjects with pain-related symptoms of TMD, i.e., facial pain acid "pain at jaw rest", a nd in men with "pain on jaw movement", compared with non-pain subjects (p < 0.05). Other symptoms of TMD also associated significantly with SCL-25 DS ( p >0.05), except "difficulties in mouth opening" among women. Among women, the prevalence of recognized depression was also significantly higher in su bjects with pain-related symptoms of TMD, compared with subjects with no pa in (p less than or equal to0.05). Almost all the associations remained sign ificant after adjusting for marital status, education, and self-rated gener al health. In conclusion, the results show that depression has an associati on with TMD symptoms, especially those related to pain. When treating patie nts with facial pain, dentists should consider the possible presence of psy chopathology and, if necessary, consult appropriate mental health professio nals.