Psychosocial, Behavioral, and Quality of Life Insights in TMDs: A Comparative Exploration of Young and Mature Patients

Objective: Despite its global adoption and translation, studies reporting age-stratified Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and II findings remain scarce. This study aimed to 1) compare TMD diagnostic categories, psychosocial/behavioral profiles, and Oral Health-related Quality of Life (OHRQoL) across age groups, 2) explore correlations between psychosocial/behavioral variables and OHRQoL, and 3) identify factors associated with low OHRQoL among Chinese adult TMD patients. Methods: A total of 798 participants were recruited from a dental hospital and categorized into: young (YA: 18– 44), mature patients (MA: 45– 64), and old patients (OA: ≥ 65 years). They were assessed using DC/TMD Axis I procedures and Axis II measures for depression, anxiety, oral behaviors, and jaw function. OHRQoL was evaluated with the Oral Health Impact Profile for TMDs. Statistical analyses were performed using Chi-square/non-parametric tests and logistic regression (α = 0.05). Results: The final sample included 798 participants (79.6% women), of whom 88.0%, 11.0%, and 1.0% were YA, MA, and OA, respectively. Significant differences in education level (YA > MA/OA), intra-articular TMDs (YA > MA), jaw overuse behaviors (YA > MA/OA), jaw functional limitation (MA > YA), and OHRQoL (MA > YA) were observed. Moderate correlations were noted between OHRQoL and depression, anxiety, and jaw functional limitation ( rs = 0.50– 0.61) across all groups, as well as between jaw overuse behavior and both depression and anxiety ( rs = 0.43– 0.45) for the MA group. Conclusion: Mature (MA/OA) TMD patients exhibited reduced oral behaviors but experienced greater jaw function and OHRQoL impairments. TMD pain doubled the likelihood of low OHRQoL. Clinical Relevance: Age-related differences in physical diagnosis, oral behaviors, jaw function, and OHRQoL are evident among TMD patients. Older individuals exhibit fewer oral behaviors but face greater jaw limitations and poorer OHRQoL, highlighting the importance of tailored management across age group. Keywords: temporomandibular disorders, age, psychosocial, oral behaviors, oral health-related quality of life