Clinical and Psychological Profiles of Patients With Subclinical Versus Self-Reported Painful Temporomandibular Disorders

Abstract

Objective: To compare clinical examination findings, functional limitations, and psychological profiles between patients with subclinical temporomandibular disorders (TMD) and those with self-reported painful TMD. Materials and Methods: This cross-sectional study investigated 98 subclinical TMD patients and 262 self-reported painful TMD patients attending a specialised orofacial pain clinic. Subclinical TMD was defined as positive palpation findings without muscle or joint pain complaints. Self-reported painful TMD required both pain complaints and positive clinical findings. Validated questionnaires assessed jaw functional limitations (JFLS-20), depression (PHQ-9), stress (SPST-20), and oral behaviours (OBC). Statistical analysis used Mann–Whitney U tests and chi-square tests with Bonferroni correction. Results: Self-reported painful TMD patients were significantly older (median age 39 vs. 31 years, p = 0.003), showed greater jaw functional limitations (JFLS global score: 1.88 vs. 0.75, p < 0.001), and higher depression scores (PHQ-9: 1.0 vs. 0.0, p < 0.001). Sleep bruxism frequency differed significantly between groups (p < 0.001), with subclinical patients more commonly reporting frequent sleep bruxism. No significant differences were found in stress levels, overall oral behaviours, or daytime clenching frequency. Conclusions: Patients with self-reported painful TMD demonstrate distinct clinical profiles characterised by greater functional impairment and psychological distress compared to subclinical cases. Clinical Relevance: These findings suggest different phenotypes within the TMD spectrum that may require tailored clinical approaches. Longitudinal studies are needed to determine whether subclinical TMD represents an early stage or a distinct entity.