Self-reported temporomandibular disorder pain in a multi-ethnic, Southeast Asian population: prevalence and health impact

Abstract Background The prevalence of painful temporomandibular disorders (TMDs) has been well studied in various countries, but not in multi-ethnic Singapore where pain development, presentation, impact, and reporting may be influenced by cultural, genetic and environmental factors. This study is an initial step toward assessing the prevalence of self-reported TMD pain amongst adult Singaporeans and its impact on health-related quality of life (HRQoL). Methods Adult participants (≥ 21 years) were randomly recruited using a two-stage stratified sampling. Data was collected in 2017 using a multilingual, structured questionnaire, including TMD screening, pain drawing, Graded Chronic Pain Scale (GCPS) and HRQoL using EQ-5D-5L and EQ-VAS. Non-parametric tests (p < 0.05), logistic regression, and mediation analyses were used to evaluate associations between TMD status, sociodemographic factors, and HRQoL. Results 1600 participants (39.8% invitees) completed the survey. Depending on questions used, self-reported TMD pain prevalence was 1.7% or 13.0%. TMD pain was significantly associated with HRQoL dimensions (EQ-5D), although weakly associated with poorer overall health status (EQ VAS). GCPS increase was also associated with a decrease in EQ VAS health status. 22.7% of participants indicated pain in the face, head or neck region from the pain drawings, of which 99.7% also indicated body pain. There were no statistically significant differences in TMD pain prevalence between ethnic groups. Conclusions TMD pain prevalence appeared strongly influenced by question wording bias, supporting the need of validated questions in Singapore. This study highlights that the choice of screening tool affects prevalence estimates, which could have direct influence on patient care, perceived diseased burden and the allocation of healthcare resources. Compared to no pain, TMD pain is significantly associated with slightly lower HRQoL, in a culturally and ethnically diverse Southeast Asian population. Graphical Abstract