Prevalence of Temporomandibular Disorders in India: A Systematic Review

Figure 1. PRISMA flowchart

Sno

Author/ year

Type of study

Region

Tool used

Study population

Prevalence

Findings

1

Rajesh Shetty et al. 2010 [16]

Cross sectional

Mangalore

Constructed questionnaire,

Clinical examination

healthy, asymptomatic edentulous patients not wearing complete dentures

59%

Over half of the asymptomatic patients experienced TMD symptoms, but they had no idea of them; 59% of the subjects had at least one TMD symptom. TMDs were more common in women (62.5%) than in men (56.6%).

2

Amita Aditya et al. 2012 [17]

Cross-Sectional study5

Pune

Case history and constructed questionnaire, Clinical examination

Adults who are institutionalized or receiving outpatient care due to a psychosocial illness diagnosis

subjective TMD symptoms to be 12%, objective TMD symptoms present in 19.5% of participants

Patients with psychosocial issues do not seem to have an abnormally high frequency of TMJ dysfunction symptoms.  Despite the fact that there is considerable comorbidity between these two illnesses, no obvious connection could be found.

3

Priyanka Modi et al. 2012 [18]

Cross sectional

Loni

Fonseca questionnaire

Medical and dental students

45.16%

This student group had a significant frequency of TMD; nevertheless, the majority of illnesses were moderate. There was no analytically substantial correlation between TMD intensity and sexuality.

4

Saraswati K. Gopal et al. 2014 [19]

Cross sectional

Chennai

Case history and constructed questionnaire, Clinical examination

Patients in Private dental college

60%

Since there was no discomfort, several of the asymptomatic individuals were unaware of the underlying issue with their TMJ.

5

Kaberi Majumder et al. 2015 [20]

Cross sectional study

Gurgaon

Helkimo anamnestic index (Ai) and clinical dysfunction index (Di)

Student in 5 different colleges

64.4%

TMD was highly prevalent among students and was strongly linked to anxiety and sadness.

6

Asawa et al. 2015 [21]

Cross-Sectional study

Dungarpur District

clinical examination according to WHO proforma

General population

21.4%

Men were more impacted than women, and TMJ signs and symptoms were more common in the 45–54 age range. TMJ symptoms were substantially correlated with skeletal fluorosis (33.0%).

7

Jivnani et al. 2017 [22]

Cross sectional

Lucknow

DC/TMD,

hospital anxiety and depression

scale

(HADS),

T-Scan

Student in Private dental college

17%

TMD was significantly correlated with both functional occlusal measures and psychological factors.

8

Ahuja et al. 2018 [23]

cross sectional study

Gaziabad

Clinical evaluation

and

questionnaire along with

perceived stress scale (PSS).

Students in Private dental college

30.6%

One important etiologic factor that contributes to the development and maintenance of TMDs in dentistry students is stress. The age range of 21 to 25 years old was shown to have the highest prevalence of TMDs, with MPDS predominating. Females had the highest incidence of disc displacement (66.0%) and were shown to have a greater prevalence of TMDs than males.

9

Reshmi et al. 2018 [24]

Cross sectional

Kozhikode

Helkimo index

Clinical examination

Partially edentulous patients in OPD of dental college

57.4%

TMD was more common in women than in men, and it was more common in individuals with Kennedy's class I mandibular condition and a combination of maxillary class I and mandibular class II situations. Although TMD symptoms decreased with age, the difference was not statistically significant.

10

Banerjee et al. 2019 [25]

Cross sectional

Lucknow

Self-reported questionnaire

Dental students in private dental college

30%

The most often reported symptoms among the students were TMJ sound, headache, and earache.

11

Dr. Preeti Nair et al. 2018 [26]

Cross sectional

Bhopal

Case history and constructed questionnaire ,  Clinical examination

Patients visiting Private dental college

55.3%

The results of this study indicated that younger people, particularly women, were at a higher risk of getting TMDs. Overstretching when yawning (31%), parafunctional behaviors (34%), jaw trauma (23%), dental treatment (8%), and traumatic dental treatment (4%) were factors that contributed to TMD.

12

Sandhya Jain et al. 2018 [27]

Cross sectional

Indore

Fonseca’s Questionnaire

Patients under orthodontic treatment in dental college

25.3%

In the age group of 19 to 30, a considerably higher proportion of girls than men presented with TMDs. Age-related increases in TMD prevalence are also seen.

13

Pradeepta Kaushal et al. 2018 [28]

Cross sectional study

Indore

Case history and constructed questionnaire, Clinical examination

Helkimo Index

Student in Private dental college

18.6%

Stress showed a highly significant value and was the primary cause for TMD. The most common sound found was clicking, and the affected muscle was the lateral pterygoid (27%), showing prevalence in females.

14

Pooja Bhave et al. 2019 [29]

Cross sectional

Navi-Mumbai

RDC/TMD

Student in Private dental college

51%

It is possible that symptoms do not always accompany the indicators of TMDs. Prior to signs appearing, patients can remain asymptomatic for an extended length of time.

15

Thomas et al.

2020 [30]

Cross sectional

Central kerala

Case history and constructed questionnaire,  Clinical examination

Students from professional colleges

48%

The current investigation in professional institutions found that TMD was more common in men.

16

Varsha Ushakar et al. 2020 [31]

cross sectional study

Ernakulam

Fonseca questionnaire

Students in Private dental college

59.3%

Age has been shown to have a substantial impact on the severity of TMD, but the individual's sex had no discernible effect.

17

Swapna Bettanapalya Venkatesh et al. 2021 [32]

Cross sectional

Manipal

RDC/TMD   Perceived Stress Scale (PSS) questionnaire

Student in Private dental college

30.7%

Substantial correlation between stress, TMDs, and salivary cortisol levels.

18

Kumari Sonam Jha et al. 2021 [33]

Cross sectional study

Jharkhand

Case history and constructed questionnaire, Clinical examination

Patient in Private dental college

1.25%

According to the factors that were examined, clicking was the most prevalent symptom.

Incidence of TMD decreases as the age of an individual advances. More common in females compared to males,

19

Ajay Kumar et al. 2021 [34]

cross sectional study

Mangalore

RDC/TMD criteria.

Professional swimmers

13.54 %

Competitive swimmers are prone to TMDs.

TMD was linked to more than an hour of practice per day and more than five days of practice.  TMD was more common among swimmers who used the backstroke.

20

Munazza et al. 2020 [35]

Comparative Study

Mangalore

Fonseca’s Anamnestic index and Zung’s Self-rating Anxiety Scale.

Students in Private dental college

46%

Preclinical students had a larger percentage of stress, whereas clinical students had a higher percentage of TMD.

The degree of stress was significantly correlated with TMD. Compared to male students, the prevalence and severity of TMD were greater among female students.

21

Sanjana Devi et al. 2021 [36]

Retrospective study

Chennai

Previous data, case history

Patients in Private dental college

0.8%

Disc displacement was more prevalent and TMD was more prevalent in men.

And the age range of 30 to 39 was the most impacted.

22

Jayant

Prakash et al. 2022 [37]

cross-sectional study

Muzaffarpur

Case history and constructed questionnaire, Clinical examination

Patients in Private dental college

35.7% of the elderly population

More females were affected compared to males.  Subjects who reported bruxism had a significantly higher prevalence of TMD symptoms.

23

Jaishankar et al. 2023 [38]

Cross sectional

India

online questionnaire

Musicians and vocalist

50.8%

Playing an instrument raises the likelihood of acquiring TMD, and playing the wind instrument puts one at greater risk.

24

Ramachandran et al. [39]

2023

Cross-sectional Study.

Pondicherry

Case history records

Patients in Private dental college

1%

Women were more likely than males to report having TMJ discomfort.  Joint noises and discomfort were the most often reported symptoms.

25

Chinthalapalli et al. 2024 [40]

Cross-sectional Study

Davangere

DC-TMD

Dental students

61.2 %.

TMDs are more likely to occur among dental students, especially those participating in clinical programs, and are closely associated with increased stress levels.

Cochran's Q

df

P

I²

Tau Squared (T²)

220.129

24

0

89.097%

0.041

Prevalence

Raw Prevalence

SE of transformed

Prevalence

Variance

Weight

Normal Approximation interval

Lower Bound

Upper Bound

0.35923

0.35923

0.01422

0.0002

4946.89545

0.33136

0.38709

Figure 2. Forest Plot

Figure 3. Doi Plot for publication bias

SN

Study

Were the requirements to be included in the sample well-defined?

Were the research participants and environment thoroughly explained?

Were the measurements of exposure accurate and legitimate?

Were the conditions measured using unbiased, accepted standards?

Have complicating variables been discovered?

Were methods for handling complicating variables mentioned?

Were the measurements of the results accurate and legitimate?

Was suitable analytical assessment applied?

Score

Quality

1

Shetty R et al. 2010

Y

N

Y

Y

N

N

N

Y

0.5

Moderate

2

Aditya A et al. 2012

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

3

Modi P et al. 2012

Y

N

N

N

N

N

N

Y

0.3

Low

4

Gopal SK et al. 2014

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

5

Majumder K et al. 2015

Y

Y

Y

Y

N

N

Y

Y

0.8

High

6

Asawa  K et al. 2015

Y

Y

Y

Y

N

N

Y

Y

0.8

High

7

Jivnani HM et al. 2017

N

N

Y

Y

N

N

N

Y

0.4

Moderate

8

Ahuja V et al. 2018

N

N

Y

Y

N

N

Y

Y

0.5

Moderate

9

Reshmi M et al. 2018

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

10

Banerjee A et al. 2019

N

N

N

N

N

N

N

Y

0.1

Low

11

Nair P et al. 2018

N

N

Y

Y

N

N

Y

Y

0.5

Moderate

12

Jain S et al. 2018

Y

N

N

N

N

N

Y

Y

0.4

Moderate

13

Kaushal P et al. 2018

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

14

Bhave P et al. 2019

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

15

Thomas AS et al. 2020

N

N

N

N

N

N

N

Y

0.1

Low

16

Ushakar V et al. 2020

N

N

N

N

N

N

N

Y

0.1

Low

17

Venkatesh SB et al. 2021

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

18

Jha KS et al. 2021

Y

N

Y

Y

N

N

Y

Y

0.6

Moderate

19

Kumar A et al. 2021

Y

Y

Y

Y

N

N

Y

Y

0.8

High

20

Munazza S et al. 2024

Y

Y

N

N

N

N

N

Y

0.4

Moderate

21

Devi S et al. 2021

Y

Y

UC

UC

Y

N

UC

Y

0.5

Moderate

22

Prakash J et al. 2022

Y

Y

Y

Y

N

N

Y

Y

0.8

High

23

Jaishankar HP et al. 2023

Y

Y

N

N

N

N

N

Y

0.4

Moderate

24

Ramachandran S 2023

Y

Y

N

N

N

N

Y

Y

0.5

Moderate

25

Chinthalapalli SJ et al. 2024

Y

Y

Y

Y

N

N

Y

Y

0.7

High