A cross-sectional study of the association between anxiety and temporomandibular disorder in Australian chiropractic students

J Chiropr Educ. 2019 Oct;33(2):111-117. doi: 10.7899/JCE-18-3. Epub 2019 Feb 5.


Objective: This study examined the association between anxiety and temporomandibular disorder (TMD) in Australian chiropractic students, particularly its effect on quality of life.

Methods: Chiropractic students (n = 185) completed online surveys, including the Oral Health Impact Profile for TMDs (OHIP-TMD) and the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. The OHIP-TMD psychometric properties were assessed using principal component analysis. Linear regression models were used to examine demographic predictors for anxiety and TMD. A general linear model assessed the association between anxiety and the psychosocial and function scales identified through analysis of the OHIP-TMD questionnaire.

Results: The mean value for the OHIP-TMD and PROMIS was 1.3 (SD = 0.7) and 9.5 (SD = 4.1), respectively. Women reported significantly lower quality of life (QoL) related to TMD symptoms (p = 0.006) and that QoL related to TMD symptoms increased significantly as students progressed through the course (p = .025). Lower levels of anxiety were significantly associated with male gender (p = .000), employment (p = .008), higher program levels (p = .003), and having children (p = .005). General linear model analysis revealed that increased anxiety was significantly associated with higher levels of oral physical function impairment (p = .003) and elevated psychosocial distress (p = .0001).

Conclusion: Anxiety was significantly associated with psychosocial distress and oral physical function impairment in university chiropractic students. In addition to impacting on oral health-related QoL, anxiety also affects students' engagement with learning and academic performance. It would therefore be beneficial to implement strategies that mitigate students' anxiety levels.

Keywords: Anxiety; Chiropractic; Education; Oral Health; Pain; Temporomandibular Joint Disorders.