Does difficulty in chewing induce subjective musculoskeletal symptoms? A case-control study

Naomichi Tani; Masanori Ohta; Yoshiyuki Higuchi; Ryoko Yamamoto; Junichi Akatsu

doi:10.1136/bmjopen-2021-053360

Does difficulty in chewing induce subjective musculoskeletal symptoms? A case-control study

BMJ Open. 2022 Mar 22;12(3):e053360. doi: 10.1136/bmjopen-2021-053360.

Authors

Naomichi Tani¹, Masanori Ohta², Yoshiyuki Higuchi³, Ryoko Yamamoto⁴, Junichi Akatsu⁵

Affiliations

¹ Department of Health Information Analysis and Research, The Association for Preventive Medicine of Japan, Fukuoka, Japan tani_naomichi@jpm1960.org.
² Graduate School of Health and Environmental Sciences, Fukuoka Women's University, Fukuoka, Japan.
³ Department of Health and Physical Education, University of Teacher Education Fukuoka, Fukuoka, Japan.
⁴ Department of Occupational health, The Association for Preventive Medicine of Japan, Fukuoka, Japan.
⁵ Wellbeing Mori Clinic, The Association for Preventive Medicine of Japan, Tokyo, Japan.

Abstract

Objectives: Risk factors associated with the development of musculoskeletal disorders and symptoms remain an important issue worldwide. This study aimed to investigate the relationship between oral health problems such as difficulty chewing and the occurrence of stiff neck/shoulders (SN/S) and low back pain (LBP).

Design: Case-control study.

Setting and participants: This study was conducted from 1 April 2018 to 31 March 2020. The subjects were 77 341 workers among 646 281 workers from several employers in Japan.

Outcome measures: Participants were asked to evaluate their subjective SN/S and LBP symptoms using a self-administered questionnaire.

Methods: We defined the chewing condition using a questionnaire, and workers who responded with 'I can chew anything' were classified as the good condition group (GCG), and those who responded with 'Sometimes I have difficulty chewing due to problems with the teeth, gums, or bite' or 'I can hardly chew' were classified as the poor condition group (PCG). Setting the year 2018 as the baseline, we performed a logistic regression model using propensity score and inverse probability weighting (IPW) methods and chewing condition groups as explanatory variables and SN/S and LBP as objective variables.

Results: The IPW-adjusted logistic regression model showed that the OR of SN/S was approximately 1.25 (95% CI 1.17 to 1.33) times higher in the PCG than that in the GCG (p<0.001). Similarly, the OR of LBP was about 1.37 (95% CI 1.27 to 1.48) times higher in the PCG than that in the GCG in the IPW-adjusted logistic regression model (p<0.001).

Conclusions: Our study suggests that the occurrence of SN/S and LBP symptoms in workers could be predicted depending on the presence of difficulty in chewing. Therefore, oral health and health guidance are gaining importance for the prevention of subjective musculoskeletal symptoms.

Keywords: musculoskeletal disorders; occupational & industrial medicine; oral medicine; public health.

MeSH terms

Case-Control Studies
Humans
Low Back Pain* / epidemiology
Mastication
Musculoskeletal Diseases* / epidemiology
Occupational Diseases* / epidemiology
Risk Factors
Surveys and Questionnaires