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Prevalence and normative values for Jaw Functional Limitations in the general population in Sweden
Malmö University, Faculty of Odontology (OD). Department of Oral Basic Sciences, Taibah University, Medina, Saudi Arabia; Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden.
Malmö University, Faculty of Odontology (OD). Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.ORCID iD: 0000-0002-9638-4648
Division of Epidemiology and Community Health and Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, Minnesota.
Malmö University, Faculty of Odontology (OD). Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden.ORCID iD: 0000-0001-6088-3739
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2019 (English)In: Oral Diseases, ISSN 1354-523X, E-ISSN 1601-0825, Vol. 25, no 2, p. 580-587Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: For jaw functional limitations measured by the Jaw Functional Limitation Scale (JFLS), (a) determining prevalence in the Swedish general adult population, (b) investigating the influence of demographic factors and self-reported dental status and (c) deriving normative values. METHODS: A random sample of the general adult population in Sweden was approached (response rate: 46%, N = 1,372). Prevalence was determined for the JFLS summary score and individual items. The influence of age, gender and dental status was investigated with regression analyses and normative values presented. RESULTS: The JFLS median score was 0, and all items had prevalences ≤30%. Age and gender did not influence jaw functional limitations but dental status did. Normative JFLS scores were 1, 9 and 28 for the 7th, 8th and 9th deciles, respectively. In dental status-stratified norms, 9th deciles were 20, 43 and 100, for subjects with natural teeth only, removable and complete dentures, respectively. CONCLUSIONS: The Swedish general adult population had excellent jaw function, but dental status was major determinant. In the absence of information linking JFLS scores to important patient concerns, the score distribution can serve as a reference with the 9th decile as threshold for functional limitation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 25, no 2, p. 580-587
Keywords [en]
dental diseases, epidemiology, jaw function, normative values, pain, public health
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-15495DOI: 10.1111/odi.13004ISI: 000458899300025PubMedID: 30447172Scopus ID: 2-s2.0-85058043486Local ID: 27086OAI: oai:DiVA.org:mau-15495DiVA, id: diva2:1419016
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2025-01-22Bibliographically approved
In thesis
1. Jaw Function and Oral Health-Related Quality of Life: Relation between Temporomandibular Disorders and other Oral Conditions
Open this publication in new window or tab >>Jaw Function and Oral Health-Related Quality of Life: Relation between Temporomandibular Disorders and other Oral Conditions
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The focus of this thesis was two major patient-reported outcomes: quality of life and jaw function. Different study designs were used to examine the prevalence, impact, and predictive factors of orofacial conditions, with a focus on temporomandibular disorders (TMD) and their effects on oral health-related quality of life (OHRQoL). The findings in the different parts of the thesis provide a comprehensive understanding of the burden these conditions reflect on individuals, particularly when they occur in combination. 

Orofacial conditions such as TMD, burning mouth syndrome (BMS), dry mouth, and bad breath were found to be prevalent in the Swedish adult population, with bad breath being the most commonly self-reported condition. Notably, individuals experiencing multiple conditions, which affected more than a quarter of the population surveyed, demonstrated significantly higher impairments in OHRQoL, illustrating the compounded negative effects of comorbid conditions. TMD and BMS, in particular, were associated with the most substantial impact on quality of life, emphasizing the difference between painful and non-painful conditions. 

Limitations in jaw function, another key focus, were generally low among the Swedish adult population. However, age and the presence of dental prostheses were identified as significant predictors of increased limitations. This highlights the importance of considering both demographic and dental factors when evaluating jaw function. The study also established normative values for jaw function, offering a benchmark for clinical assessment of orofacial dysfunction. A score of 28 or higher on the Jaw Functional Limitation Scale was found to have clinical significance. 

In terms of orofacial pain conditions, including TMD, odontogenic pain, oral mucosal pain, and pain following third molar extractions, were all found to have a moderate impact on the pain dimension of OHRQoL. The highest burden was observed in patients with pain after 3rd molar extraction, although all four pain conditions resulted in a notable reduction in quality of life. This standardized understanding of the pain-related impact on OHRQoL provides critical insight for clinicians managing patients with various orofacial pain syndromes. 

Longitudinal analysis of TMD patients revealed that the physical component of health-related quality of life (HRQoL) over time is significantly predicted by baseline factors such as age, general health, and jaw function. Older age and poor general health were associated with worse physical HRQoL in painful TMD cases, whereas impaired jaw function was particularly relevant in non-painful TMD cases. Interestingly, no significant predictive factors were identified for the mental component of HRQoL, suggesting the need for further research into the psychological dimensions of TMD and other orofacial conditions. 

Overall, this thesis provides evidence that orofacial conditions, particularly TMD, have a significant and multidimensional impact on both oral and general quality of life. By integrating cross-sectional and longitudinal data, this work offers valuable insights into the epidemiology, functional consequences, and long-term predictors of quality of life in individuals with orofacial conditions. 

Abstract [sv]

Den här avhandlingen undersöker hur orofaciala besvär påverkar livskvalitet och käkfunktion, med särskilt fokuspå temporomandibulär dysfunktion (TMD). Den belyser hur vanliga dessa tillstånd är i den svenska vuxna befolkningen och vilken påverkan de harpå vardagslivet. Orofaciala tillstånd som TMD, burning mouth syndrome (BMS), muntorrhet och dålig andedräkt identifierades som vanliga, där dålig andedräkt var det mest rapporterade besväret. Studien visar att personer som lider av flera av dessa besvär samtidigt, vilket omfattade mer än en fjärdedel av de undersökta individerna, upplever en betydande försämring av sin orala hälsorelaterade livskvalitet (OHRQoL). Detta visar hur kombinationen av olika besvär kan förstärka den negativa påverkan på både munhälsa och livskvalitet. Bland dessa tillstånd hade TMD och BMS den största negativa inverkan, särskilt när smärta var en del av problematiken. 

En annan viktig del av avhandlingen var att undersöka käkfunktion, som hos de flesta vuxna i Sverige visade sig vara relativt opåverkad. Dock identifierades vissa grupper med större begränsningar, där äldre personer och de som använder tandproteser var särskilt utsatta. Dessa fynd understryker vikten av att ta hänsyn till både ålder och tandstatus vid bedömning av käkfunktion. För att ytterligare stödja kliniska bedömningar etablerade studien riktvärden för käkfunktion, vilket ger tandläkare och vårdgivare bättre verktyg för att utvärdera och behandla orofaciala besvär. Till exempel fann man att ett värde på 28 eller högre på skalan för käkfunktionsbegränsning (JFLS) har klinisk betydelse och kan användas för att identifiera individer med allvarligare käkproblem. 

Smärta var en annan central aspekt av avhandlingen. Olika typer av smärta, inklusive smärta relaterad till TMD, odontogen smärta, smärta i munslemhinnan och smärta efter kirurgi (borttagning av visdomständer), undersöktes. Resultaten visade att alla dessa tillstånd hade en måttlig påverkan på. den smärtrelaterade dimensionen av livskvaliteten, där smärta efter visdomstandsoperation visade sig ha den största negativa effekten. Detta visar hur olika typer av smärta kan påverka människors dagliga liv och välbefinnande på olika sätt. 

En långsiktig analys av patienter med TMD visade att den fysiska delen av livskvaliteten påverkades av faktorer som ålder, allmänhälsa och käkfunktion. Äldre patienter och de med sämre allmänhälsa hade sämre fysisk livskvalitet, medan nedsatt käkfunktion var mer framträdande hos patienter med ickesmärtsamma TMD-besvär. Intressant nog kunde inga tydliga faktorer kopplas till den mentala delen av livskvaliteten, vilket tyder på att mer forskning behövs för att först. de psykologiska aspekterna av TMD och andra orofaciala tillstånd. 

Sammanfattningsvis visar denna avhandling att orofaciala besvär, särskilt TMD, har en mångfacetterad och betydande påverkan på både oral hälsa och allmän livskvalitet. Genom att kombinera data från både tvärsnittsstudier och långtidsanalyser ger forskningen värdefulla insikter i hur vanliga dessa besvär är, hur de påverkar vardagen och vilka faktorer som kan förutsäga långsiktiga effekter. Denna kunskap är viktig för att förbättra vården och livskvaliteten för personer som lever med orofaciala besvär.

Place, publisher, year, edition, pages
Malmö University Press, 2025. p. 65
Series
Malmö University Odontological Dissertations, ISSN 1650-6065, E-ISSN 2004-9307
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-73179 (URN)10.24834/isbn.9789178775057 (DOI)978-91-7877-504-0 (ISBN)978-91-7877-505-7 (ISBN)
Public defence
2025-02-14, KL:2370, Faculty of Odontology, Smedjegatan 16, Malmö, 09:15 (English)
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Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as manuscript.

Available from: 2025-01-22 Created: 2025-01-22 Last updated: 2025-01-24Bibliographically approved

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Oghli, IbrahimList, ThomasHäggman-Henrikson, BirgittaLarsson, Pernilla

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