Oral health-related quality of life in temporomandibular disorder patients and healthy subjects - a systematic review and meta-analysis

(1) Background: Temporomandibular disorders (TMD) signs and symptoms affect the quality of life of patients because they impose an incapacity to participate in daily life activities, causing both physical and psychological discomfort. This review aims to provide the most accurate, comprehensive, and up-to-date description of all information available regarding OHRQoL in TMD. 

(2) Methods: A systematic search of articles from January 2013 till August 2023 was performed on five databases to identify articles, including TMD and oral health-related quality of life. Two calibrated reviewers performed the search following inclusion and exclusion criteria. A manual search of reference articles was also performed. The data were analyzed qualitatively by combining a meta-analysis and GRADE evidence. The Newcastle-Ottawa scale for cross-sectional and case-control studies was utilized to assess the quality of the included studies. 

(3) Results: The initial search consisted of 738 articles without the removal of duplicates. Fifteen articles were included in this systematic review, and ten were included in the meta-analysis. Almost all the included observational studies reported poor OHRQoL among patients with different types of TMD. The results of the meta-analysis with a standard mean difference (SMD) and that included seven studies suggest high heterogeneity with I2 = 99%, SMD (95% CI) = 3.18 (1.90, 4.46), p-value < 0.01. The odds ratio analyzed for three included articles in the meta-analysis reported statistical significance (p-value < 0.01) with OR = 8.21 (2.39, 28.25) and a heterogeneity of 86%. The certainty of evidence by GRADE resulted in a downgraded level of evidence, indicating that the OHRQoL of TMD patients may differ slightly from the healthy controls. 

(4) Conclusions: The impact of OHRQoL on the TMD was deemed to be significant. Overall, the OHRQoL is low for any type and intensity of pain among TMD patients and controls.