Article_5_2_6
GERODONTOLOGY
Original Article
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH
AND WITHOUT TEMPOROMANDIBULAR DISORDERS
Minh Son Nguyen1,2a*, Ülle Voog-Oras1b, Triin Jagomägi1c, Mare Saag1d
1
Institute of Dentistry, Faculty of Medicine, University of Tartu, Raekoja plats 6, 51003 Tartu, Estonia
2
Department of Prosthodontics, Faculty of Stomatology, Danang University of Medical Technology and Pharmacy, 99 Hung Vuong, Danang, Vietnam
a
DDS, PhD, Head of Department
b
MD, PhD, Associate Professor
c
DDS, PhD, Associate Professor
d
DDS, PhD, Professor, Head of Institute
ABSTRACT DOI: 10.25241/stomaeduj.2018.5(2).art.6
Introduction: Temporomandibular disorders (TMD) are a group of disorders that may OPEN ACCESS This is an
cause functional limitations. The aim of the study was to compare the differences in dental Open Access article under the CC
status, oral behaviour, and mandibular functional limitations between TMD and non-TMD BY-NC 4.0 license.
Peer-Reviewed Article
elderly people in Vietnam.
Methodology: The sample consisted of 146 TMD and 112 non-TMD elderly. The dental and Citation: Nguyen MS, Voog-Oras Ü,
Jagomägi T, Saag M. Comparison of dental
periodontal status were evaluated with DMFT and CPI indices. The participants self-rated status and oral function in the elderly with
frequency of oral behaviour activities (21-item Oral Behaviour Checklist) and mandibular and without temporomandibular disor-
ders. Stoma Edu J. 2018;5(2):118-124.
functional limitations (20-item Jaw Functional Limitation Scale).
Results: The mean number of missing teeth in TMD group was 9.6 ± 8.6, while it was 7.6 ± Academic Editor: Hiroshi Ogawa, DDS,
MDSc, PhD, Associate Professor, Niigata
6.4 in non-TMD group (p = 0.036). Gingival bleeding in TMD group was detected at 18.3 ± University, Niigata, Japan
10.2 teeth, which was less than in non-TMD group (21.0 ± 8.7, p = 0.023). The mean number Received: May 22, 2018
of sextants with a 0–3 mm clinical attachment loss was high for non-TMD group (1.4 ± 2.0, Revised: May 28, 2018
Acccepted: June 18, 2018
p = 0.021), while the mean number of excluded sextants was high for TMD group (1.3 ± 1.8, Published: June 20, 2018
p = 0.037). The TMD elderly group reported more frequent instances of “Hold, tighten, or
*Corresponding author: Dr. Minh Son
tense muscles” than non-TMD group. No significant differences were found in the self-rated Nguyen, DDS, PhD Institute of Dentistry,
mandibular functional limitations between the two groups. Faculty of Medicine, University of Tartu 6
Raekoja Plats, Tartu 51003, Estonia. Tel:
Conclusion: TMD were associated with missing teeth and periodontal diseases. There was +84983060321, Fax: +372 7319856, e-mail:
no association between TMD and mandibular functional limitations. The elderly suffering minhson1883@gmail.com
from TMD tended to have increased frequency of holding, tightening, or tensing muscles. Copyright: © 2018 the Editorial Council
Keywords: dental caries, elderly, mastication, oral function, temporomandibular disorders. for the Stomatology Edu Journal.
1. Introduction factors of ageing contribute to the increasing signs
Temporomandibular disorders (TMD) are the group of of TMD, including limited mouth opening, muscular
disorders affecting the temporomandibular joint and tenderness, and TMJ sounds, all of which can affect
structure-related joint. The prevalence of TMD in the on masticatory performance. Ohrbach et al. [13] and
older adult population varies from 33% to 56.6% [1,2]. Markiewicz et al. [14] initially developed the Diagnostic
TMD often cause orofacial pain, limit the function of Criteria for Temporomandibular Disorders (DC/TMD)
the masticatory system, and also impact on quality of axis II to determine the presence of parafunctional
life [3]. and functional limitations of the masticatory system.
Multiple factors contribute to the TMD process. However, norms have not yet been established for those
Dentition is a part of the masticatory system, and instruments, particularly in the older adult population.
the global burden of dental caries and periodontal Regardless of whether or not elderly with TMD have
diseases can increase the risk of TMD in the older adult more limited oral function compared to those free
population [4]. Our previous studies indicate that more from TMD, because many factors such as dental status,
than 50% suffer from TMD [2]. Studies on TMD at the neuromuscular changes, and psychosocial factors can
age over 60 years old also reported that 17.5–52.2% influence oral function of this age group.
of patients had less than 20 teeth, and 10.9–34.3% Therefore, the aim of the study was to compare the
were edentulousness [5–7]. After dental pain, TMD is differences in dental status, oral behaviours, and
the most the common cause of pain in the orofacial functional limitations of the masticatory system
area; therefore, dental diseases and TMD may share between the TMD and non-TMD elderly people.
symptoms and clinical comorbidities.
The parafunctional habits of bruxism and teeth
clenching have been regarded as risk factors for 2. Materials and methods
TMD pain [8–10]. TMD patients are also limited in The total sample comprised 258 volunteer participants
their daily activities and have increased frequency aged 65–74 years in Danang City, Vietnam. Based on
of oral parafunction [11,12]. The cumulative risk clinical examination of TMD according to DC/TMD axis
118 Stoma Edu J. 2018;5(2): 118-124 http://www.stomaeduj.com
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH AND WITHOUT
TEMPOROMANDIBULAR DISORDERS
I [15], our previous study revealed that 56.6% (n = 146)
Original Article
Table 1. Comparisons of dental caries status between the TMD and non-
of the total sample were diagnosed with TMD (TMD TMD elderly participants.
group) and 43.4% (n = 112) were free of TMD (non- TMD Non-TMD
TMD group) [2]. In the current study, the participants of Variable p-value
(n = 146) (n = 112)
both groups were invited to examine dental status and Sound teeth
evaluate oral function.
Written informed consent that explained oral Number of subjects 131 110
examination procedures was obtained from each Percent % 89.7 98.2 0.009*a
participant. This study was registered and approved by Mean number of teeth 15.5 ± 9.4 17.6 ± 8.7 0.070
the Human Research Ethics Committee of the Danang Decayed teeth
University of Medical Technology and Pharmacy
(No. 523/CN-DHKTYDDN 2014) and was performed Number of subjects 120 108
in accordance with the World Medical Association’s Percent % 82.2 96.4 < 0.001*a
Helsinki Declaration. Mean number of teeth 6.3 ± 5.6 6.5 ± 5.4 0.684
Missing teeth
2.1. Clinical examination of dental status
The dental status of each participant was examined Number of subjects 134 106
by using the Decayed Missing Filled Teeth (DMFT) Percent % 91.8 94.6 0.463
index. The primary caries appeared on the crown or Mean number of teeth 9.6 ± 8.6 7.6 ± 6.4 0.036*b
root of a tooth, or secondary carious lesions nest to the Filled teeth
restoration was considered a decayed tooth (DT). A
missing tooth (MT) was a tooth lost due to caries or any Number of subjects 12 10
other reason. A filled tooth (FT) was considered with Percent % 8.3 8.9 1.000
at least one filled surface and without any caries. The Mean number of teeth 0.2 ± 0.9 0.3 ± 1.1 0.710
DMFT score was the sum of the DT, MT, and FT scores Caries experience
and ranged from 0 to 32.
Number of subjects 143 111
2.2. Clinical examination of periodontal status Percent % 97.9 99.1 0.635
Periodontal status was evaluated using the modified Mean DMFT 16.0 ± 9.5 14.4 ± 8.7 0.152
Community Periodontal Index (CPI). The modified CPI
records two indicators of periodontal status: gingival a
Fisher’s exact test, b Student t-test, * statistically significant
bleeding and periodontal pockets. All teeth present TMD: Temporomandibular disorders, DMFT: Decayed Missing
Filled Teeth
were probed (6 sites per tooth) to record any presence
of bleeding on probing and periodontal pocket depth (JFLS-20) [13] and the frequency of parafunctional
(PPD). PPD was scored as follows: score 0 (a PPD of behaviours based on the 21-item Oral Behaviour
0-3mm, no pocket), score 1 (a PPD of 4–5mm, shallow Checklist (OBC-21) [14].
pocket), and score 2 (a PPD of ≥ 6mm, deep pocket). JFLS-20 assesses the limitation of mastication (6 items),
mandibular mobility (4 items), verbal and emotional
2.3. Clinical examination of clinical attachment loss expression communication items (8 items), swallowing,
(CAL) and yawning. Each item was scored on a scale of 0–10
CAL estimates accumulated lifetime destruction of the points (10 points = the most limited mandibular
periodontal attachment. CAL was measured from the function).
cementoenamel junction to gingival sulcus or pocket at OBC-21 determines the frequency of oral parafunctional
6 sites per index tooth of each sextant. The CAL severity activities during sleep and waking hours. Each item was
was recorded based on the highest CAL score of the scored from 0 (never) to 4 (all the time). In the current
index tooth as follows: score 0 (CAL 0–3 mm), score 1 study, each item on the JFLS-20 and OBC-21 surveys
(CAL 4–5 mm), score 2 (CAL ≥ 6 mm). The sextant was was categorised as No (score = 0) and Yes (score ≥ 1).
excluded if there were less than two teeth present. The data was analysed using Version 17.0 of the
The first author conducted procedure of dental and Statistical Package for Social Sciences software (SPSS
periodontal examination according to the WHO’s Oral Inc., Chicago, Ill., USA). The comparisons of dental
Health Survey guidelines (2013). A pilot study of a status, the frequency of parafunctional behaviours,
group of 25 elderly people was performed to calibrate and functional limitations of the masticatory system
the examiner before the study was carried out. Ten between the two groups was performed using Chi-
percent of the participants were re-examined after square test and Student’s t-test. A confidence level of
three days to test the reliability of the examination 95% and a two-sided p-value of < 0.05 were used to
procedure. The calculated Kappa-values were above reveal significant differences.
0.85, indicating a high degree of intra-examiner and
inter-examination reliability.
3. Results
2.4. Evaluation of oral function Prevalence of DMFT was 97.9% in the TMD group
All participants were interviewed face-to-face on the and 99.1% in the non-TMD group (p = 0.635). There
functional limitations of their masticatory system were significant differences in prevalence between
based on the 20-item Jaw Functional Limitation Scale the TMD and the non-TMD groups in terms of sound
Stomatology Edu Journal 119
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH AND WITHOUT
TEMPOROMANDIBULAR DISORDERS
Original Article Table 2. Comparisons of periodontal status between the TMD and non-
TMD elderly.
Table 3. Comparisons of functional limitations of masticatory system be-
tween the TMD and non-TMD elderly.
TMD Non-TMD TMD Non-TMD
Variable p-value (n = 146) (n = 112) p-
(n = 146) (n = 112) Functional limitation
valuea
Gingival bleeding No. % No. %
Chew tough food 120 82.2 85 75.9 0.215
Number of 135 (92.5) 110 (98.2) 0.467
participants (%) Chew hard bread 97 66.4 63 56.3 0.095
Mean number of 18.3 ± 10.2 21.0 ± 8.7 0.023*c Chew chicken 101 69.2 72 64.3 0.407
teeth Chew crackers 62 42.5 46 41.1 0.822
Mastication
Prevalence of participants having highest score of PPD Chew soft food 35 24.0 27 24.1 0.980
PPD 0–3 mm 15 (10.7) 15 (13.4) 0.514 Eat soft food requiring no
17 11.6 15 13.4 0.673
chewing
PPD 4–5 mm 46 (32.9) 50 (44.6) 0.056
Number of limitation
PPD ≥ 6 mm 78 (55.7) 47 (42.0) 0.030*a 3.0 ± 1.9 2.8 ± 2.1 0.400
items (maximum = 6)b
Mean number of teeth present with PPD Mean score of each item
2.55 (0.17) 2.26 (0.19) 0.264
PPD 0 –3 mm 12.3 ± 10.2 14.4 ± 9.7 0.085 (SE)b
Open wide enough to bite
PPD 4–5 mm 7.3 ± 7.9 8.3 ± 8.1 0.342 26 17.8 18 16.1 0.713
from a whole apple
PPD ≥ 6 mm 1.0 ± 3.6 0.6 ± 1.7 0.210 Open wide enough to bite
34 23.3 26 23.2 0.989
Mandibular mobility
Prevalence of participants having highest score of CAL into a sandwich
CAL 0–3 mm 2 (1.4) 12 (10.7) 0.001*b Open wide enough to talk 27 18.5 21 18.8 0.958
CAL 4–5 mm 38 (26.0) 42 (37.5) 0.048*a Open wide enough to
26 17.8 19 17.0 0.859
drink from a cup
CAL ≥ 6 mm 45 (30.8) 25 (22.3) 0.128
Number of limitation
0.8 ± 1.5 0.8 ± 1.4 0.896
Excluded sextants 61 (41.8) 33 (29.5) 0.042*a items (maximum = 4)b
Mean number of sextants with CAL and excluded sextants Mean score of each item
0.49 (0.09) 0.43 (0.08) 0.659
(SE)b
CAL 0–3 mm 0.9 ± 1.4 1.5 ± 2.0 0.021*c
Talk 11 7.5 11 9.8 0.514
CAL 4–5 mm 2.4 ± 2.0 2.7 ± 2.2 0.184
Sing 25 17.1 19 17.0 0.973
Verbal and emotional expression
CAL ≥ 6 mm 1.5 ± 1.7 1.0 ± 1.7 0.100
Putting on a happy face 12 8.2 11 9.8 0.654
Excluded sextants 1.2 ± 1.8 0.8 ± 1.4 0.037*c Putting on an angry face 12 8.2 12 10.7 0.494
a
Chi-square test, b
Fisher’s exact test, Student’s to-test, *
c
statistically significant. Frown 15 10.3 13 11.6 0.733
PPD: Periodontal pocket depth; CAL: Clinical attachment loss. Kiss 14 9.6 10 8.9 0.856
Smile 23 15.8 17 15.2 0.899
teeth (89.7% and 98.2%, p = 0.009) and decayed teeth
(82.2% and 96.4%, p < 0.001). The number of missing Laugh 15 10.3 14 12.5 0.575
teeth was statistically higher in the TMD group (9.6 ± Number of limitation
± 2.1 1.0 ± 2.2 0.752
items (maximum = 8)b
8.6 teeth) than in the non-TMD group (7.6 ± 6.4, p =
0.036, Table 1). Mean number of each
0.23 (0.05) 0.21 (0.05) 0.774
item (SE)b
Regarding periodontal status, gingival bleeding was
detected at 18.3 ± 10.2 teeth in the TMD group, which Swallow 19 13.0 14 12.5 0.903
was lower than 21.0 ± 8.7 teeth in the non-TMD group Yawn 22 15.1 17 15.2 0.980
(p = 0.023). The prevalence of older adults with PPD Number of limitation
4.9 ± 4.9 4.7 ± 5.4 0.815
≥ 6 mm was higher in the TMD group (55.7%) than items in JFLS-20b
in the non-TMD group (42%, p = 0.030). Concerning Total score of JFLS-20
19.8 ± 18.6 17.6 ± 17.6 0.348
clinical attachment loss, occurrences of CAL 4–5 mm ± SDb
was 37.5% for the non-TMD group and 26.0% for the
a
Chi-square test, Student’s t-test. TMD: Temporomandibular
b
disorders, SE: standard error, JFLS-20: 20-item Jaw Functional
TMD group (p = 0.048); whereas, a high prevalence of Limitation Scale.
excluded sextants was significantly related to the TMD
group (41.8%, p = 0.042). The mean number of sextants of the masticatory items was 2.55 (0.17) for the TMD
with CAL 0–3 mm was 0.9 ± 1.4 in the non-TMD group, group, compared to 2.26 (0.19) for the non-TMD
which was statistically lower than 1.5 ± 2.0 sextants group (p = 0.260). The prevalence of limitations of
of the non-TMD group (p = 0.021); however, the TMD mandibular mobility ranged from 17.8% to 23.3% in
group had more excluded sextants (1.3 ± 1.8) than the the TMD group, which were similar with the variation
non-TMD group (0.7 ± 1.4, p = 0.037). of 16.1% to 23.2% in the non-TMD group (p > 0.05).
Comparing the functional limitations of mastication There were no significant differences between the two
revealed no differences between the TMD and non- groups regarding limitations of verbal and emotional
TMD group. Most participants in the TMD elderly expression. The total score of JFLS-20 was 19.8 ± 18.6 in
group had masticatory limitations related to chewing the TMD group and 17.6 ± 17.6 in the non-TMD group
tough food (82.2%), followed by chewing chicken (p = 0.348, Table 3).
(69.2%), and chewing hard bread (66.4%); the results There were significant differences in the prevalence
for the non-TMD group were 75.9%, 64.3%, and 56.3%, of parafunctional activities between the TMD and
respectively. The mean score (standard error) of each non-TMD groups in terms of “Hold, tighten, or tense
120 Stoma Edu J. 2018;5(2): 118-124 http://www.stomaeduj.com
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH AND WITHOUT
TEMPOROMANDIBULAR DISORDERS
muscles without clenching” (7.5% and 1.8%, p =
Original Article
Table 4. Comparisons of parafunctional behaviours between the TMD
0.036) and “Eating between meals that food requires and non-TMD elderly.
chewing” (43.2% and 57.1%, p = 0.026). The TMD group TMD Non-TMD
also tended to have more prevalent parafunctions Parafunctional habit (n = 146) (n = 112) p-
of “Press tongue forcibly against teeth” and “Place valuea
n % n %
tongue between teeth” (p = 0.067 and p = 0.079,
Sleep activities
respectively) compared to the non-TMD group. No
significant differences were found in the mean number Clench or grind teeth when
16 11.0 9 8.0 0.431
asleep
of parafunctional items between the two groups (p =
0.928, Table 4). Sleep in a position that puts
57 39.0 44 39.3 0.968
pressure on the jaw
Waking activities
4. Discussion Grind teeth together during
9 6.2 7 6.3 0.977
waking hours
The current study highlighted a different dental status
between the TMD elderly and non-TMD elderly groups. Clench teeth together during
12 8.2 10 8.9 0.840
waking hours
Our TMD elderly group lost an average of 9.6 ± 8.6 teeth
and were higher than the non-TMD group; in other Press, touch, or hold teeth
together other than while 28 19.2 24 21.4 0.655
words, our study was in accordance with previous eating
findings indicating that there was association of TMD
Hold, tighten, or tense muscles
with missing teeth [16–18]. When individuals lose without clenching
11 7.5 2 1.8 0.036*
many teeth, their chewing pattern can be changed and Hold or put jaw forward or to
have impact on masticatory performance. Numerous the side
17 11.6 11 9.8 0.641
studies indicated that chronic unilateral chewing Press tongue forcibly against
increases the risk of TMD [18,19]. In addition, tooth 31 21.2 14 12.5 0.067
teeth
loss causes social limitations, psychological disorders, Place tongue between teeth 32 21.9 15 13.4 0.079
and reduces the quality of life, all of which have been
Bite, chew, or play with your
regarded as factors contributing to TMD. tongue, cheeks or lips
27 18.5 19 17.0 0.750
The main finding of our study was that periodontal Hold jaw in rigid or tense
diseases have influence on TMD. PPD ≥ 4 mm indicates position
17 11.6 10 8.9 0.480
periodontal tissue destruction due to inflammation, Hold between the teeth or bite
while the CAL measurement estimates lifetime 8 5.5 8 7.1 0.583
objects
accumulated destruction of the periodontal attachment. Use chewing gum 20 13.7 19 17.0 0.468
These measures permit comparisons the severity of Play musical instrument that
periodontal diseases between population groups. Our involves use of mouth or jaw
4 2.7 1 0.9 0.392
finding indicated that PPD and CAL were worse in the Lean with your hand on the jaw 50 34.2 36 32.1 0.722
TMD group than in the non-TMD group. More than
Chew food on one side only 82 56.2 63 56.3 0.989
half of the TMD group had PPD ≥ 6 mm and over 70%
of those had the CAL ≥ 6 mm and excluded sextants. Eating between meals that food
63 43.2 64 57.1 0.026*
requires chewing
All these numbers were comparatively high compared
Sustained talking 67 45.9 49 43.8 0.732
to 42% and 51.8%, respectively, in the non-TMD group.
In the elderly population, periodontal diseases are the Singing 33 22.6 34 30.4 0.159
most frequent cause of tooth loss; therefore, TMD was Yawning 48 32.9 43 38.4 0.353
significantly associated with both periodontal diseases Hold telephone between your
10 6.8 6 5.4 0.622
and tooth loss in the current study. head and shoulders
Gingival bleeding does not affect single tooth but Number of parafunctional habits
can affect many remaining teeth in the mouth, but 0 15 10.3 12 10.7
the TMD group had more missing teeth than the non-
1–4 72 49.3 54 48.2
TMD. Therefore, the number of teeth with gingival 0.921
bleeding was observed less in the TMD group in our 5–8 36 24.7 31 27.7
study. Periodontal inflammation has been considered a ≥9 23 15.8 15 13.4
potential risk factor for other diseases. Proinflammatory Mean number of
4.40 ± 3.71 4.36 ± 3.23 0.928
cytokines enhance the pathogenesis of periodontal parafunctional habits ± SDb
diseases. Interleukin (IL-1) and tumour necrosis factor
a
Chi-square test, Student’s t-test, statistically significant.
b *
TMD: Temporomandibular disorders, SD: standard deviation.
alpha (TNF-α) represent proinflammatory cytokines
that stimulate a number of events which occur during Regarding peripheral sensitization, nociceptive
infection with periodontal pathogens. Graves et al. afferents in the periodontal ligament could be activated
found a widespread presence of IL-1 and TNF in the when periodontal tissues under pressure become
connective tissue and loss of alveolar bone along with painful due to bacterial infections. Afferent nerve
periodontal inflammation [20]. High levels of IL-1 and fibres carry the impulse to the trigeminal spinal tract
TNF-α are a response to the inflammatory process and nucleus and stimulate interneurons. The efferent fibres
they might penetrate into the TMJ synovial fluid and of the inhibitory interneurons synapse, which lead to
cause bone tissue resorption; therefore, the degree of the elevator muscle reaction, bring the teeth away
endogenous cytokine control is important for bone from the noxious stimulus [22,23]. These repetitions
tissue destruction in the TMJ structure [21]. might cause masticatory muscle dysfunction. The
Stomatology Edu Journal 121
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH AND WITHOUT
TEMPOROMANDIBULAR DISORDERS
findings of Jeon et al. [19] suggested a positive elderly, including chronic orofacial pain, psychological
Original Article correlation between chronic periodontitis and TMD- disorders, and age-related reduction of the motor
related muscle pain, while Fabri et al. [24] found that function of masticatory muscles [29–31]. The important
there were clinical comorbidities between periodontal finding of the current study was that determining the
disease and craniofacial pains. All these studies support JFLS-20 score of older adults might enable us to predict
our findings indicating that periodontitis accumulated TMD, as the prevalence of TMD is correlated with an
over time might be a risk factor for TMD. increasing JFLS-20 score in the general population [13].
TMD are a group of disorders that disrupt function The limitation of the study was that we only studied
or cause parafunction of the masticatory system. the oral function and parafunctional behaviours based
Surprisingly, the number of oral parafunctional on self-rated questionnaires. There is a need for more
activities was equal across two groups; participants clinical research on this aspect.
in both groups had a range of 4–5 parafunctional
behaviours. Our study is in accordance with Leketas et
al.’s study [25] indicating that the behaviours of “Lean 5. Conclusion
with your hand on the jaw”, “Chew food on one side Temporomandibular disorders were associated with
only”, and “Sleep in a position that puts pressure on the missing teeth and periodontal diseases. There was no
jaw” were the most common in the TMD group. Meulen association between TMD and mandibular functional
et al. [26] showed that these parafunctional behaviours limitations among the elderly. The elderly suffering
often had higher scores than other parafunctional from TMD tended to have increased frequency of
items when evaluating the validity items of OBC-21 holding, tightening, or tensing muscles.
in the Dutch population. This could suggest that the
frequency of parafunctional behaviours affected TMD.
The current study found that 2 out of 21 items of OBC Conflicts of interest
were significantly associated with TMD among the The authors declare that they have no conflict of
elderly. The TMD group had higher frequency of “Hold, interest.
tighten, or tense muscles without clenching”, but a
lower frequency of “Eating between meals (i.e., food
that requires chewing)” than the non-TMD group. These Author contributions
findings could be explained by muscular activity. The MSN searched literature, performed clinical studies,
increase in the frequency of tensing muscles heightened data acquisition and statistical analysis, and wrote draft
the risk of TMD between 2.9 – 10.8 times [25]. Based on of manuscript. ÜVO, TJ, and MS designed protocol,
an electromyography study, Ohrbach et al. found [27] interpreted data, and edited the manuscript. All
a high score of masseter muscular activity in subjects authors read and approved the final manuscript.
with tense muscles. A high activity of masseter muscle
in combination with the neuromuscular change in
older age would cause muscular disorders, a subgroup Acknowledgements
of TMD. This also explained why the TMD elderly group This study was supported by the Estonian Science
had a lower frequency of eating between meals in our Foundation grant ESF 9255, the Estonian Research
study because of muscular impairment. Council IUT 20-46, and the Internationalization
The current study reported difficulty chewing tough Programme DoRa of the European Social Fund, which is
and hard food in most participants, but none indicating carried out by the Foundation Archimedes. The authors
that TMD was related to functional limitations of would like to thank the volunteer participants from the
mastication; such findings contrast with findings of Hoa Vang, Hai Chau, Thanh Khe, and Cam Le districts
Brandini et al. [28]. In older adults, the rate of loss was of Danang City in Vietnam for their cooperation and
often higher in the posterior than the anterior teeth; agreement to provide data on their oral health and
therefore, the impaired masticatory performance was temporomandibular joint status.
prevalent in both groups in our study. There were no
differences between the two groups concerning other
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Minh Son NGUYEN
DDS, PhD
Department of Prosthodontics, Faculty of Stomatology
Danang University of Medical Technology and Pharmacy
99 Hung Vuong, Danang, Vietnam
CV
Dr. Minh Son Nguyen completed dental curriculum at the Hue University of Medicine and Pharmacy, Vietnam (2001–2007).
He has been the lecturer of the Danang University of Medical Technology and Pharmacy Vietnam since 2008 and appointed as
the Head of the Department of Prosthodontics in 2014. More than ten articles were published in international peer-reviewed
journals, four manuscripts have been submitted for publication, and fourteen abstracts were presented at international
conferences, all of which are his scientific achievements during the period of the Doctoral curriculum at the University of Tartu,
Estonia (2014–2018). His research interest is related to prosthodontics, community dental health, geriatric dentistry, occlusion,
orofacial pain, and temporomandibular disorders.
Stomatology Edu Journal 123
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH AND WITHOUT
TEMPOROMANDIBULAR DISORDERS
Questions
Original Article
1. What is true for temporomandibular disorders (TMD)?
qa. TMD mainly cause parafunctional behaviors;
qb. The most prevalent orofacial pain is from TMD;
qc. It only affects temporomandibular joint;
qd. TMD signs tend to increase with aging.
2. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) axis II is
used to evaluate:
qa. Clinical signs of temporomandibular disorders;
qb. Quality of life related to temporomandibular disorders;
qc. Psychological domains and oral function;
qd. The balance of occlusion.
3. Which is not considered as oral parafunction:
qa. Limited mouth opening;
qb. Bruxism;
qc. Clenching;
qd. Unilateral chewing habit.
4. Prevalence of edentulousness among TMD population is:
qa. 0–5%;
qb. 11–35%;
qc. 51–70%;
qd. Over 80%.
https://clinicaldentistry.dentistryconferences.com/
124 Stoma Edu J. 2018;5(2): 118-124 http://www.stomaeduj.com