Psychosocial and behavioral factors associated with temporomandibular disorder symptoms in university athletes: a cross-sectional study

Abstract

Temporomandibular disorder symptoms are common in young adults and may be influenced by psychosocial and behavioral factors. This study estimated the prevalence of self-reported TMD symptoms and examined associated factors among university athletes in Lima, Peru. An analytical cross-sectional study was conducted in 2023 among 203 team-sport athletes from two private universities located in metropolitan Lima, Peru. TMD symptoms were assessed using the Fonseca Anamnestic Index. Anxiety and stress were measured with the corresponding subscales of the Depression Anxiety Stress Scales-21. Sleep duration, cigarette consumption, mouthguard use, and sociodemographic and sport-related characteristics were self-reported. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression with robust variance. TMD symptoms were reported by 137 participants (67.5%), mainly as mild or moderate symptoms. In the adjusted model, moderate anxiety was associated with TMD symptoms (PR = 1.41; 95% CI, 1.05–1.89), as was any daily cigarette consumption (PR = 1.38; 95% CI, 1.13–1.68). Mouthguard use showed an inverse association (PR = 0.56; 95% CI, 0.32–0.98), although this estimate was based on 16 users. Age, sex, stress level, and sleep duration were not associated with TMD symptoms after adjustment. Self-reported TMD symptoms were frequent among university athletes. Moderate anxiety and daily cigarette consumption were associated with higher symptom prevalence. The inverse association observed for mouthguard use was based on a small exposure group and should be considered exploratory. Longitudinal studies using standardized clinical diagnostic criteria are needed to confirm these findings.