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

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

The Journal of Prosthetic Dentistry
Volume 97, Issue 5, May 2007, Pages 305-309

Oliver Schierz Dr Med Dent a, Mike T. John DDS, PhD, MPh b, Ernst Schroeder c, and Frank Lobbezoo DDS, PhD d
a- Assistant Professor, Department of Prosthetic Dentistry and Materials Science, University of Leipzig
b- Associate Professor, Department of Prosthetic Dentistry and Materials Science, University of Leipzig; Affiliate Assistant Professor, Department of Oral Medicine, University of Washington, Seattle
c- Data collector, TNS Healthcare GmbH, Munich, Germany
d- Professor, Section of Oral Kinesiology, Academic Centre of Dentistry Amsterdam (ACTA) University of Leipzig, Leipzig, Germany; Academic Centre of Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

Available online 3 June 2007.

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.

Reprint requests to: Dr Oliver Schierz, Department of Prosthetic Dentistry and Materials Science, University of Leipzig, N?rnberger Str. 57, 04103 Leipzig, GERMANY, Fax: 0049-341-9721329

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