PT  - JOURNAL ARTICLE
AU  - Yuanyuan Li
AU  - Ming Fang
AU  - Lina Niu
AU  - Yu Fan
AU  - Yan Liu
AU  - Yong Long
AU  - Xiaodong Liu
AU  - Franklin R. Tay
AU  - Jihua Chen
TI  - Associations among gastroesophageal reflux disease, mental disorders, sleep and chronic temporomandibular disorder: a case–control study
AID  - 10.1503/cmaj.181535
DP  - 2019 Aug 19
TA  - Canadian Medical Association Journal
PG  - E909--E915
VI  - 191
IP  - 33
4099  - http://www.cmaj.ca/content/191/33/E909.short
4100  - http://www.cmaj.ca/content/191/33/E909.full
SO  - CMAJ2019 Aug 19; 191
AB  - BACKGROUND: Temporomandibular disorders (TMDs) are a family of pain-related disorders associated with impaired function in the jaw, temporomandibular joint and muscles of mastication. Our objectives were to evaluate the association between chronic TMD and gastresophageal reflux disease (GERD) and to determine whether mental disorders or undermined sleep mediates this association.METHODS: We conducted a case–control study involving 1522 consecutive adult patients with chronic TMD and 1522 matched controls from 2 hospitals in China. All participants were aged between 18 and 70 years and were recruited from July 2017 to April 2018 Chronic TMD was diagnosed by trained dentists using the criteria in the Orofacial Pain Prospective Evaluation and Risk Assessment Study. Trained gastroenterologists made blinded diagnoses of GERD according to the Montreal definition and classification (at least 2 d of mild symptoms, or 1 d of moderate or severe symptoms per week). We used validated questionnaires to evaluate psychological status and sleep quality.RESULTS: Of the study participants, we identified 132 patients and 61 controls with GERD. Using conditional logistic regression analysis, we identified GERD as a risk factor for TMD (odds ratio 2.74, 95% confidence interval 1.88 to 3.98). Mediation analyses identified that somatization, anxiety and undermined sleep moderately mediated the relation between TMD and GERD.INTERPRETATION: Our study suggests that symptomatic GERD is associated with chronic, painful TMD, and somatization, anxiety and undermined sleep mediate this association to a certain extent. Due consideration should be given to the evaluation and management of gastrointestinal symptoms and mental disorders in the combined therapy for painful TMD.