Association between waking-state oral behaviours, according to the oral behaviors checklist, and TMD subgroups

Objectives: To assess the association between waking-state oral behaviours and temporomandibular disorder (TMD) subgroups and to develop new scoring methods for the Oral Behavior Checklist (OBC). Methods: Patients with any TMD diagnosis, according to the diagnostic criteria for TMD (DC/TMD), were divided into subgroups: ‘Dysfunctional-TMD’ (n = 70), only mechanical dysfunction; ‘Painful-TMD’ (n = 204), only myalgia, arthralgia or both; and ‘Painful-Dysfunctional TMD’ (n = 95), combined pain and dysfunction. A group of individuals without TMD, ‘Non-TMD’ (n = 374), was used for testing associations. Participants completed the OBC. An exploratory factor analysis, followed by a confirmatory factor analysis of the OBC responses, identified 2 major factors, named non-functional activities (NFA) and functional activities (FA). Component total scores were computed. Differences among subgroups for OBC-MS (mean score) and NFA and FA factor scores were estimated using one-way ANOVA and Tukey post hoc tests. Significance was set at p <.05. Results: The OBC-MS in Non-TMD, Painful-TMD and Painful-Dysfunctional TMD subgroups was higher than in the Dysfunctional-TMD subgroup (p ≤.001). NFA in Painful-TMD and Painful-Dysfunctional TMD subgroups were higher than in the Non-TMD group (p <.05); NFA in the Dysfunctional-TMD subgroup were lower than in the Painful-TMD subgroup (p =.034). In contrast, FA in Painful-TMD, Dysfunctional-TMD and Painful-Dysfunctional TMD subgroups were lower than in the Non-TMD group (p <.0001). Conclusions: A new scoring method for the OBC results in item reduction and creation of meaningful subscales for functional and non-functional behaviours, which are differentially associated with painful and dysfunctional TMDs. This may help clinicians to better tailor treatment for the management of subtypes of TMD patients.