Mastication and mobility limitations, sex differences, and biopsychosocial predictors of jaw functional limitations in Chinese patients with temporomandibular disorder

Abstract

Abstract Objectives To describe jaw function characteristics using the Chinese version of the Jaw Function Limitation Scale (JFLS) and to explore the impact of biopsychosocial risk factors on limitations in jaw function among Chinese patients with temporomandibular disorder (TMD). Materials and Methods This study included 488 Chinese patients with TMD. All patients completed the Chinese version of the JFLS; behavioral, psychometric, and self-report questionnaires; and clinical examinations. Results Limitations associated with TMD included restricted jaw mobility and mastication, both of which exceeded the median global functional limitations scale scores, particularly for opening the mouth to bite an apple and for chewing tough foods. Women reported greater jaw mobility and global limitations than men did. On multivariate logistic regression analysis, the diagnosis subgroup, pain intensity, oral behaviors, and anxiety were predictive of high limitations in jaw function. In the mediation analysis, oral behaviors and pain intensity mediated the relationship between anxiety and jaw function limitations. Conclusions Chinese patients with TMD principally reported restrictions in mastication and jaw mobility, with more pronounced limitations in women than men. The diagnosis subgroup, pain intensity, oral behaviors, and anxiety were significant predictors of limitations in jaw function. Anxiety not only significantly predicted jaw function limitations but also increased the degree of jaw function limitations by increasing oral behaviors and exacerbating pain. Clinical Relevance: Clinically, improving adverse emotional states, such as anxiety, could reduce oral behaviors and relieve painful symptoms, thereby improving limitations in jaw function, particularly in women.