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Natl J Maxillofac Surg. 2018 Jul-Dec;9(2):147-154. doi: 10.4103/njms.NJMS_20_18.

Study of stress-induced temporomandibular disorders among dental students: An institutional study.

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Department of Oral Medicine and Radiology, D J College of Dental Sciences and Research, Ghaziabad, Uttar Pradesh, India.
Department of Oral and Maxillofacial Surgery, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India.


Aim and Objectives:

The aim and objectives of this study are to investigate the various types of stress-inducing factors, most prevalent etiological factor and to determine the correlation between stress and temporomandibular disorders (TMDs) in Dental students in Modinagar, Ghaziabad, Uttar Pradesh.

Materials and Methods:

A sample of 450 students were selected for the study divided into two groups of undergraduate (UG) and postgraduate (PG) students further subdivided into UG (1st, 2nd, 3rd, and 4th, interns) and PG (1st, 2nd, 3rd year). Study includes clinical evaluation of temporomandibular joint (TMJ) system (TMJ sounds, muscles of mastications, mouth opening, and range of mandibular motion) and questionnaire which covers demographic data (i.e., age, sex, and academic year), TMD symptoms and TMD signs along with standardized scales related to stress dental environmental stress scale and perceived stress scale (PSS).


Most of the students included into study are mostly of 21-25 years of age (64.3%), males (52.7%), females 47.3% with more number of UGs (91.4%) predominantly 1st year students (23.9%). Headache was found to be the most prevalent TMD symptom (26.2%) followed by clicking (24.9%), pain on clicking (5.5%), jaw lock (3.4), and difficulty in mouth opening (0.9%). Clicking was found to be the most prevalent TMD sign (24.9%) among dental students followed by deviation (16.3%), muscle tenderness (14.3%), and TMJ pain (5.7%). The most prevalent TMD was disc displacement 22.6% followed by myofascial pain dysfunction syndrome (MPDS) with disc displacement (13.5%) and MPDS (3.8%). TMD was higher in UG females students of 21--25 years of age group, dental environment stress scale score and PSS score shows statistically significant results.


Stress is a significant etiologic factor involved in initiation and maintenance of TMDs in Dental students.


Dental environment stress scale; disc displacement; perceived stress scale; stress; temporomandibular disorders

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