Temporomandibular disorders and dietary changes: A cross-sectional survey

Abstract

Background: Advice about a 'soft diet' may be useful in the short-term alleviation of temporomandibular disorders (TMD) but may contradict the long-term aims of multi-dimensional approaches if a poor nutritional state is caused or exacerbated. The changes patients with TMD make to their diet, because of their condition or its management, have not previously been explored.

Objectives: To explore the relationship and trends between TMD, TMD interventions and diet using self-report measures.

Methods: Registrants of the Temporomandibular Joint Association (TMJA) were invited to participate. After completing a screening questionnaire to check for eligibility, participants completed a questionnaire exploring demographics, TMD interventions and dietary habits, as well as jaw functional limitation scale (JFLS) score, graded chronic pain scale score, self-assessed limitation of opening and patient health questionnaire 4 (PHQ-4). This was followed by a validated 3-day electronic diet diary. Descriptive and inferential statistics were used to explore the data for trends and differences in the dietary intake of those participating according to various strata including demographic variables; experience of surgery; other interventions for TMD; duration of TMD; and limitation of mouth opening.

Results: Eighty-five registrants of the TMJA completed the questionnaire, of which 42 (49%) completed the 3-day diet diary. Most participants (66/85 [77.6%]) reported modifying their diet due to their TMD. The most common modification was to cut food into smaller pieces (61/85 [71.8%]) followed by boiling until soft (36/85 [42.4%]) and mashing (34/85 [40%]). Higher JFLS scores were associated with participants reduced enjoyment of food (t(83) = 2.78, p = .007), limitations in the foods they can eat (t(83) = 2.99, p = .004), necessity for modified food preparation (t(83) = 3.38, p = .001) and self-reported weight change (F(2, 82) = 9.31, p = .0002).

Conclusion: This study suggests a significant proportion of patients with TMD make alterations to their diet which may impact the nutritional value of their diet. However, self-reported symptoms and interventions for TMD made little difference to nutritional intake as measured by a 3-day diary. Patients reporting self-assessed limited opening had more pain as measured by validated tools, suggesting patients' self-reporting of opening is a useful proxy for clinical measurement in monitoring TMD.

Keywords: diet; mastication; pain; surveys and questionnaires; temporomandibular joint disorders; therapeutics.