I [15], our previous study revealed that 56.6% (n = 146)
of the total sample were diagnosed with TMD (TMD
group) and 43.4% (n = 112) were free of TMD (non-
TMD group) [2]. In the current study, the participants of
both groups were invited to examine dental status and
evaluate oral function.
Written informed consent that explained oral
examination procedures was obtained from each
participant. This study was registered and approved by
the Human Research Ethics Committee of the Danang
University of Medical Technology and Pharmacy
(No. 523/CN-DHKTYDDN 2014) and was performed
in accordance with the World Medical Association’s
Helsinki Declaration.
2.1. Clinical examination of dental status
The dental status of each participant was examined
by using the Decayed Missing Filled Teeth (DMFT)
index. The primary caries appeared on the crown or
root of a tooth, or secondary carious lesions nest to the
restoration was considered a decayed tooth (DT). A
missing tooth (MT) was a tooth lost due to caries or any
other reason. A filled tooth (FT) was considered with
at least one filled surface and without any caries. The
DMFT score was the sum of the DT, MT, and FT scores
and ranged from 0 to 32.
2.2. Clinical examination of periodontal status
Periodontal status was evaluated using the modified
Community Periodontal Index (CPI). The modified CPI
records two indicators of periodontal status: gingival
bleeding and periodontal pockets. All teeth present
were probed (6 sites per tooth) to record any presence
of bleeding on probing and periodontal pocket depth
(PPD). PPD was scored as follows: score 0 (a PPD of
0-3mm, no pocket), score 1 (a PPD of 4–5mm, shallow
pocket), and score 2 (a PPD of ≥ 6mm, deep pocket).
2.3. Clinical examination of clinical attachment loss
(CAL)
CAL estimates accumulated lifetime destruction of the
periodontal attachment. CAL was measured from the
cementoenamel junction to gingival sulcus or pocket at
6 sites per index tooth of each sextant. The CAL severity
was recorded based on the highest CAL score of the
index tooth as follows: score 0 (CAL 0–3 mm), score 1
(CAL 4–5 mm), score 2 (CAL ≥ 6 mm). The sextant was
excluded if there were less than two teeth present.
The first author conducted procedure of dental and
periodontal examination according to the WHO’s Oral
Health Survey guidelines (2013). A pilot study of a
group of 25 elderly people was performed to calibrate
the examiner before the study was carried out. Ten
percent of the participants were re-examined after
three days to test the reliability of the examination
procedure. The calculated Kappa-values were above
0.85, indicating a high degree of intra-examiner and
inter-examination reliability.
2.4. Evaluation of oral function
All participants were interviewed face-to-face on the
functional limitations of their masticatory system
based on the 20-item Jaw Functional Limitation Scale
Stomatology Edu Journal
Table 1. Comparisons of dental caries status between the TMD and non-
TMD elderly participants.
Variable
TMD
(n = 146)
Non-TMD
(n = 112)
p-value
Sound teeth
Number of subjects 131 110 Percent % 89.7 98.2 0.009 *a
15.5 ± 9.4 17.6 ± 8.7 0.070
Mean number of teeth
Decayed teeth
Number of subjects 120 108 Percent % 82.2 96.4 < 0.001 *a
6.3 ± 5.6 6.5 ± 5.4 0.684
Mean number of teeth
Missing teeth
Number of subjects 134 106 Percent % 91.8 94.6 0.463
9.6 ± 8.6 7.6 ± 6.4 0.036 *b
Mean number of teeth
Filled teeth
Number of subjects 12 10 Percent % 8.3 8.9 1.000
0.2 ± 0.9 0.3 ± 1.1 0.710
Mean number of teeth
Caries experience
Number of subjects 143 111 Percent % 97.9 99.1 0.635
16.0 ± 9.5 14.4 ± 8.7 0.152
Mean DMFT
a
Fisher’s exact test, b Student t-test, * statistically significant
TMD: Temporomandibular disorders, DMFT: Decayed Missing
Filled Teeth
COMPARISON OF DENTAL STATUS AND ORAL FUNCTION BETWEEN THE ELDERLY WITH AND WITHOUT
TEMPOROMANDIBULAR DISORDERS
(JFLS-20) [13] and the frequency of parafunctional
behaviours based on the 21-item Oral Behaviour
Checklist (OBC-21) [14].
JFLS-20 assesses the limitation of mastication (6 items),
mandibular mobility (4 items), verbal and emotional
expression communication items (8 items), swallowing,
and yawning. Each item was scored on a scale of 0–10
points (10 points = the most limited mandibular
function).
OBC-21 determines the frequency of oral parafunctional
activities during sleep and waking hours. Each item was
scored from 0 (never) to 4 (all the time). In the current
study, each item on the JFLS-20 and OBC-21 surveys
was categorised as No (score = 0) and Yes (score ≥ 1).
The data was analysed using Version 17.0 of the
Statistical Package for Social Sciences software (SPSS
Inc., Chicago, Ill., USA). The comparisons of dental
status, the frequency of parafunctional behaviours,
and functional limitations of the masticatory system
between the two groups was performed using Chi-
square test and Student’s t-test. A confidence level of
95% and a two-sided p-value of < 0.05 were used to
reveal significant differences.
3. Results
Prevalence of DMFT was 97.9% in the TMD group
and 99.1% in the non-TMD group (p = 0.635). There
were significant differences in prevalence between
the TMD and the non-TMD groups in terms of sound
119