Academic Stress and Temporomandibular Disorder Symptoms in Dental Students: Preliminary Cross-Sectional Study Findings on Prevalence, Severity, and Associated Factors.

Authors

Basem H Al-Huthaifi, Ehab M Abdu, Abdullmalik N Al-Hamati, Mohammed M Al Moaleem, Khalid Aldhorae, Baker M Abdullah, Ali H Al-Surri, Helal Y Al-Sabri, Saleh L Alnamer, Awab M Al-Hattami, Talal M Alghurbani, Mohannad A Al-Safani

Published in

Clinical, cosmetic and investigational dentistry. Volume 18. Pages 632129. Epub Aug 28, 2026.

Abstract

Temporomandibular disorders (TMD) are prevalent among dental students who are exposed to significant academic stressors. However, the relationship between stress severity and TMD symptomatology remains poorly characterized. This study assessed the prevalence of TMD symptoms, academic stress, and their associations among dental students.
This multicenter, classroom-based survey invited 850 undergraduate dental students at five universities. Of 792 returned questionnaires (return rate, 93.2%), 756 were included in the final analysis (88.9% of those invited). TMD symptoms were screened with the Fonseca Anamnestic Index (FAI), academic stress with a locally adapted 10-item Dental Environment Stress Scale (DESS)-derived measure, and six selected Brief COPE items for coping strategies. The multivariable logistic model included age, gender, year of study, marital status, sleep duration, prior TMD diagnosis, screen time, caffeine intake, and physical activity.
FAI-positive TMD symptoms (FAI ≥20) were reported by 56.6% of participants. Academic stress was moderate in 43.8% and severe in 27.5% of the participants. In adjusted analysis, female gender (AOR=1.62, 95% CI: 1.15-2.29, p=0.006) and a self-reported prior TMD diagnosis (AOR=3.32, 95% CI: 2.15-5.12, p<0.001) were associated with current FAI screen positivity. Sleep deprivation (<5 h/night) was associated with higher stress (p<0.001), but not with TMD risk. Model performance was modest (Nagelkerke R2=0.105; Hosmer-Lemeshow p=0.724). The most frequently employed coping strategies were religious/spiritual beliefs (mean 3.38±0.75) and concentrating efforts (3.15±0.72).
Self-reported TMD symptoms and academic stress were common and co-occurred in this sample. Because exposure and outcome were measured concurrently and no clinical TMD examination was performed, the associations are preliminary and should not be interpreted as causal, predictive, or diagnostic. Longitudinal studies incorporating DC/TMD examinations are needed before preventive or screening effects can be inferred.

PMID:
42683168
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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