Prevalence of temporomandibular disorders and their association with psychosocial and behavioural factors among medical and dental postgraduate residents: a cross-sectional study

Background: Temporomandibular disorders (TMD) are multifactorial conditions influenced by biological, behavioral, and psychological factors. This study aimed to determine the prevalence of TMD and to examine its association with psycho-emotional factors and oral parafunctional behaviors among postgraduate medical and dental residents using the diagnostic criteria for Temporomandibular disorders (DC/TMD). Methods: A cross-sectional analytical survey was conducted from May 2023 to January 2024 among 220 medical and dental postgraduate residents at a tertiary care hospital in Karachi, Pakistan, selected through proportionate stratified sampling. Participants completed a structured questionnaire covering socio-demographics, DC/TMD Axis I and II, the Patient Health Questionnaire (PHQ-4, PHQ-9), Generalized Anxiety Disorder scale (GAD-7), and the Oral Behaviors Checklist (OBC). Data were analyzed using descriptive statistics, chi-square tests, and logistic regression at a 95% confidence level. Results: The prevalence of undiagnosed TMD was 10%, higher among females (63.64%) and dental postgraduate trainees (28.55%). BDS qualification was significantly associated with TMD (adjusted OR: 4.28; 95% CI: 1.56–11.79). Frequent symptoms included intermittent jaw pain (80%), headaches (50%), and joint noises (50%). Participants with TMD had significantly higher mean scores for anxiety, depression, distress, and OBC (p < 0.05). Each unit increase in OBC score was associated with a 1.08-fold increase in TMD odds. No significant association was observed with workload or residency year. Conclusions: TMD in postgraduate residents is linked to psycho-emotional stress and oral parafunctional behaviors, with dental residents at greater risk. Early screening, ergonomic interventions, behavioral modification, and integrated mental health support are recommended to reduce long-term orofacial morbidity in this population.