The Open Dentistry Journal

ISSN: 1874-2106 ― Volume 14, 2020

Influence of Psychosocial Factors and Habitual Behavior in Temporomandibular Disorder–Related Symptoms in a Working Population in Japan

Akira Nishiyama1, *, Koji Kino1, Masashi Sugisaki2, Kaori Tsukagoshi1
1 Temporomandibular Joint and Oral Function, Comprehensive Oral Health Care, Comprehensive Patient Care, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
2 Department of Dentistry, Jikei University School of Medicine, Tokyo, Japan



The symptoms of temporomandibular disorders (TMD) are directly influenced by numerous factors, and it is thought that additional factors exert indirect influences. However, the relationships between TMD-related symptoms (TRS) and these contributing factors are largely unknown. Thus, the goal of the present study was to investigate influences on TRS in a working population by determining the prevalence of TRS, analyzing contributing factors, and determining their relative influences on TRS.

Materials and Methods:

The study subjects were 2203 adults who worked for a single company. Subjects completed a questionnaire assessing TRS, psychosocial factors (stress, anxiety, depressed mood, and chronic fatigue), tooth-contacting habit, and sleep bruxism-related morning symptoms, using a 5-point numeric rating scale. Our analysis proceeded in 2 phases. First, all variables of the descriptor were divided into parts by using an exploratory factor analysis. Second, this factorial structure was verified by using a confirmatory factor analysis with structural equation modeling.


Of 2203 employees, 362 reported experiencing TRS (16.4%). Structural equation modeling generated a final model with a goodness of fit index of 0.991, an adjusted goodness of fit index of 0.984, and a root mean square error of approximately 0.021. These indices indicate a strong structural model. The standardized path coefficients for “habitual behavioral factors and TRS,” “psychosocial factors and habitual behavioral factors,” “psychosocial factors and TRS,” and “gender and habitual behavior factors” were 0.48, 0.38, 0.14, and 0.18, respectively.


Habitual behavioral factors exert a stronger effect on TRS than do psychosocial factors.

Keywords: Temporomandibular disorders, habitual behavior, psychosocial factors, questionnaire, screening, structural equation modeling, .

Article Information

Identifiers and Pagination:

Year: 2012
Volume: 6
First Page: 240
Last Page: 247
Publisher Id: TODENTJ-6-240
DOI: 10.2174/1874210601206010240

Article History:

Received Date: 27/8/2012
Revision Received Date: 9/10/2012
Acceptance Date: 23/10/2012
Electronic publication date: 28/12/2012
Collection year: 2012

Article Metrics:

CrossRef Citations:

Total Statistics:

Full-Text HTML Views: 2035
Abstract HTML Views: 1037
PDF Downloads: 537
Total Views/Downloads: 3609

Unique Statistics:

Full-Text HTML Views: 958
Abstract HTML Views: 657
PDF Downloads: 244
Total Views/Downloads: 1859
Geographical View

© Nishiyama et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; Tel: +81-3-5803-5713; Fax: +81-3-5803-5713; E-mail address:


"Thank you for your magnificent and marvelous support throughout the publication stages. I would like to endorse my experience with you as a Junior Researcher and a recent graduate of the Dental school. Once again Thank you for your Great Help and Guidance throughout the stages of Publication. You guys are a great team and I am proud to be a Young Bentham author."

Asra Sabir Hussain
The University of Edinburgh Business School, UK

"My experience with Bentham Open was a valuable one because the quality of the services and analysis of my paper contributed in improving what we intended to convey to the readers."

José Ricardo Kina
Department of Surgery and Integrated Clinic,
Araçatuba School of Dentistry, São Paulo State University

"The Publication Manager was very cooperative and replied my mails and guided me without any delays; however the reviewing process was too long."

Mahtab Memarpour
Prevention of Oral and Dental Disease Research Center,
Department of Pediatric Dentistry, School of Dentistry,
Shiraz University of Medical Sciences, Shiraz,

Browse Contents

Webmaster Contact:
Copyright © 2019 Bentham Open