Incidence of TMD higher in patients with depression


This large cohort study looked at whether depression is a risk factor of temporomandibular disorder (TMD). The study used claims data from The National Health Insurance program of Taiwan which covers more than 96% of its 23 million population. From the database 7,587 patients who are newly diagnosed individuals with depression and 30,197 comparison subjects were randomly selected from a non-depression cohort. Both groups were followed from 2000-1 until the end of 2008 to measure the incidence of TMD.

They found:

  • The incidence of TMD was 2.65 times higher in the depression cohort than in the non-depression cohort (6.16 versus 2.32 per 1000 person-years).
  • Cox’s proportional hazard ratio (HR) of TMD for the depression cohort was 2.21 (95% CI 1.83–2.66), after controlling for socio-demographic factors and other psychiatric comorbidities.
  • Women had higher risk to develop TMD than men:
    • HR 1.61, 95% CI 1.36–1.92 for women without depression
    • HR 3.54, 95% CI 2.81–4.45 for women with depression.

They concluded:

A temporal relationship between depression and TMD seems to exist. These results imply that dentists involved in the management of TMD need to be aware of the comorbidity of depression in these patients.

Liao CH, Chang CS, Chang SN, Lane HY, Lyu SY, Morisky DE, Sung FC. The risk of temporomandibular disorder in patients with depression: a population-based cohort study. Community Dent Oral Epidemiol. 2011 May 30. doi: 10.1111/j.1600-0528.2011.00621.x. [Epub ahead of print] PubMed PMID: 21623863

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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