Prevalence of Temporomandibular Disorders (TMDs) in Relation to Estrogen Levels among Females in Aseer Region, Saudi Arabia

Aim: To determine the relationship between estrogen levels in females and prevalence of temporomandibular joint disorders (TMDs) in Aseer region of Saudi Arabia. Context: TMDs were considered to be the most common musculoskeletal disorders that cause orofacial pain. The complex chronic nature of TMDs may affect the quality of life negatively. Studies have shown different prevalence of TMDs among different populations which could be related to variations in methodologies, diagnostic criteria, or classifications. Females are affected more commonly than males with the highest prevalence reported during the reproductive years. One possible explanation, although debatable, is related to female reproductive hormones, especially estrogen. Estrogen could have influence on the structural development, metabolism, and physiologic pain perception of temporomandibular joints. Methodology: After theApproval taken from the Scientific Research Committee, College of dentistry, King Khalid University, Abha. A written informed consent was drawn from subjects and total of 227 Saudi and NonSaudi female subjects were selected randomly and were examined. Research Diagnostic Criteria for TMDs (RDC/TMD) Axes I and II were used for diagnosing the most common TMDs and for assessing the psychosocial and behavioral factors, respectively. Procedures followed were in accordance with the ethical standards given in the Declaration of Helsinki of 1975, as revised in 2000. Estrogen test results were retrieved from the latest hormonal analysis of estradiol (E2) blood tests and statistical analysis was done using SPSS Version 16.0. Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis tests. Results: The prevalence of TMDs in females in Aseer region is 26%. Myofascial pain is the most common diagnosis based on RDC/TMD diagnostic criteria, with 22% myofascial pain only and 4% myofascial pain with limited opening. 19.8% reproducible clicking and 9.7% clicking and catching. There was no significant difference of the estrogen levels reported. The mean value of estrogen levels reached its highest in 41-50 age groups. Conclusions: No significant association found between the tested demographic parameters and TMDs diagnosis or Estrogen levels. TMDs cases showed significantly lower Estrogen levels in comparison to normal cases which are consistent with some published studies but should be interpreted carefully. Further Investigations are needed to assess the relationship of Estrogen levels and TMDs.