New Study: Temporomandibular Disorders May Be Associated with Smartphone Addiction

*Image source: "Prevalence of Temporomandibular Disorders and Smartphone, Nicotine, and Alcohol Addiction Among University Students"

DentalGoodNews | Recently, a study published in BMC Oral Health by Toros University in Turkey, focusing on university students, revealed that patients with temporomandibular disorders (TMD) have higher rates of smartphone, nicotine, and alcohol addiction compared to healthy individuals.

The study included 641 TMD patients and 268 healthy controls. Data showed that the smartphone addiction rate among TMD patients was 44.7%, significantly higher than the 26.1% in the control group (p<0.001); nicotine addiction rates were 32.0% and 23.9% respectively (p=0.009); alcohol addiction rates were 22.3% and 14.6% respectively (p=0.004).

The research team used the Fonseca questionnaire to assess TMD severity and employed the Fagerström Test, Addiction Profile Index Risk Screening Scale (APIRSS), and Smartphone Addiction Index-Short Version (SPAI-SF) to evaluate nicotine, alcohol, and smartphone addiction levels respectively. Results showed that TMD patients scored higher than controls on depression and anxiety (PHQ-4), smartphone addiction, alcohol dependence, and nicotine dependence.

In subgroup analysis of addicted individuals, TMD patients showed higher nicotine dependence scores (median 4 points) compared to controls (median 3 points), but no significant differences were found in smartphone and alcohol addiction severity between the two groups.

Correlation analysis revealed positive associations between TMD severity and smartphone addiction (r=0.283), nicotine dependence (r=0.147), alcohol dependence (r=0.123), and depression-anxiety (r=0.489). Depression-anxiety scores also correlated positively with smartphone addiction (r=0.328), alcohol dependence (r=0.125), and nicotine dependence (r=0.120).

Multivariate logistic regression analysis showed that depression-anxiety symptoms (OR=1.29) and smartphone addiction levels (OR=1.11) were significantly associated with TMD presence. The model demonstrated high discriminative ability with 99.6% sensitivity, 98.8% specificity, and 99.4% overall accuracy.

Researchers suggest that higher rates of nicotine and alcohol addiction among TMD patients may be related to more prominent depression and anxiety symptoms. Previous studies have shown that the co-occurrence rate of chronic pain and depressive symptoms can reach 59.1%, with patients potentially using substances to cope with pain and emotional burden. Additionally, forward head posture caused by prolonged smartphone use may increase cervical load, affecting temporomandibular joint function from a biomechanical perspective.

Notably, among the 18–25-year-old university student population included in this study, the overall detection rate for TMD-related symptoms was 70.5%; among TMD patients, 71.3% were female. Researchers stated that since the study only included university students, results may not be applicable to other age groups.

Furthermore, the research team recommends that TMD treatment should consider co-existing addictive behaviors and adopt a multidimensional treatment approach. Particularly when patients present with depression and anxiety symptoms, psychological health assessment and intervention should be incorporated into treatment strategies.

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