Occlusal Sensitivity to Articulating Foils in Patients With Temporomandibular Disorders and Healthy Controls

OBJECTIVES: To compare occlusal tactile acuity (OTA), the ability to detect and discriminate occlusal contacts, between patients with chronic painful temporomandibular disorders (TMDp) and healthy controls and to examine the influence of pain and oral behaviours on foil perception. METHODS: Forty TMDp patients (34 female, 6 male) and 40 healthy controls (20 female, 20 male) completed OTA testing with foils 8-56 μm thickness and a sham stimulus (48 trials). Participants bit in maximal intercuspal position and gave yes/no responses regarding foil perception. Oral behaviours were assessed using the Oral Behaviour Checklist (OBC). Repeated-measures ANOVA evaluated group and thickness effects, and signal detection theory separated perceptual sensitivity from response bias. RESULTS: TMDp patients showed higher recognition accuracy across thin foil thicknesses, with the most robust group difference observed at 32 μm after correction for multiple comparisons. They also exhibited higher perceptual sensitivity and a more liberal response criterion. Regression analyses identified TMDp status and female sex as positive predictors of perceptual sensitivity, whereas OBC-total and OBC-night were negative predictors. Models with decision bias as the outcome showed that TMDp predicted a more liberal criterion, while all OBC subscales predicted a more conservative criterion. CONCLUSION: TMDp participants detected thinner foils more accurately but tended to overreport contact presence. In contrast, frequent oral behaviours were associated with reduced perceptual sensitivity and more conservative response tendencies.