GERD a Risk Factor for Temporomandibular Joint Disorders
NEW YORK (Reuters Health) – Gastroesophageal reflux disease (GERD) is associated with a nearly three-fold increased risk of temporomandibular disorders (TMD), according to a new case-control study.
“We found that symptomatic GERD is associated with painful chronic TMD, and somatization, anxiety and undermined sleep mediate this association moderately,” Dr. Franklin R. Tay of The Dental College of Georgia in Augusta and the Fourth Military Medical University in Shaanxi, China, and colleagues conclude.
TMDs involve pain and impaired function of the jaw, temporomandibular joint and muscles of mastication, Dr. Tay and his team explain in CMAJ, online August 19.
Following up on a case-control study from 2010 that linked TMD to GERD, the authors conducted a larger study including 1,522 consecutive chronic TMD patients and 1,522 controls from two hospitals in China.
In the TMD group, 132 patients were diagnosed with GERD, compared to 61 patients in the control group. GERD was associated with a significantly increased risk of TMD (odds ratio 2.74).
Somatization mediated 14% of the association between TMD and GERD; anxiety, 11%; and undermined sleep, 10%.
Teeth grinding or clenching, which is associated with GERD, could also contribute to jaw pain in TMD, Dr. Tay and colleagues note.
“Physicians and patients may overlook the association between chronic musculoskeletal diseases and gastrointestinal symptoms,” they write. “Patients with both chronic TMD and reflux symptoms may be underdiagnosed, resulting in deferred effective treatment and a prolonged disease course.”
They conclude: “Due consideration should be given to the evaluation and management of gastrointestinal symptoms and mental disorders in the combined therapy for painful TMD.”
Dr. Tay was not available for an interview by press time.