No association between incisal tooth wear and temporomandibular disorders

Statement of problem. Incisal tooth wear may be a sign of long-term bruxing behavior. Bruxism is purported to be a risk factor for temporomaridibular disorders (TMD). Purpose. The purpose of this clinic-based case-control study was to investigate whether the wear of anterior teeth is associated with TMD. Material and methods. Two hundred eight TMD patients and 172 control subjects were selected for participation. After exclusion of subjects with more than 1 missing premolar or molar zone in opposite arches, as well as subjects with missing or severely restored anterior teeth, 154 TMD patients and 120 control subjects were included in the study (age 31.2 ± 13.4 years; range 13 to 76 years). Anterior tooth wear was assessed on casts with a 0 to 5 scale. A multiple logistic regression analysis, controlling for the effects of age and gender, was performed to investigate the relationship between tooth wear and TMD. Results. An odds ratio of 0.76 (95% confidence interval: 0.51 to 1.15) indicated that after adjusting for gender and age, the odds in favor of TMD decreased an estimated 24% for each additional unit of the mean tooth wear score. This result was not significant (P=.20). Conclusion. Within the limitations of this study, incisal tooth wear (assessed on dental casts) was not significantly associated with TMD when the influence of age and gender was controlled. Based on these findings, a clinically relevant risk for TMD from incisal tooth wear can be excluded. Hence, the presented evidence does not support the idea that treatment of incisal tooth wear is indicated to prevent TMD.