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Bidirectional relationship between temporomandibular disorder and ankylosing spondylitis: a population-based cohort study

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Abstract

Objectives

This study aimed to determine the relation between temporomandibular disorder (TMD) and ankylosing spondylitis (AS) bidirectionally and ascertain the important comorbidities for AS occurrence in TMD patients.

Materials and methods

We conducted this population-based cohort study through Longitudinal Health Insurance Database, Taiwan. Study 1 investigated the risk of TMD in AS patients. Study 2 assessed the risk of AS in TMD patients.

Results

In total, 3204 AS patients and 12,816 age-matched and gender-matched comparisons were enrolled in study 1. The TMD incidence in the AS cohort was 2.88-fold higher when compared with the comparisons (1.54 vs. 0.53 per 10,000 person-years). After adjusting for age, gender, and comorbidity, the AS cohort had a 2.66-fold (95% CI = 1.79–3.97) increased risk of TMD occurrence (P < 0.0001). The second study recruited 4998 TMD patients and 19,991 age-matched and gender-matched comparisons. Both TMD and comparison cohorts showed similar AS risk (HR = 1.49, 95% CI = 0.91–2.43, P = 0.1108) in the adjusted model. Study 2 identified a 3.66-fold increased risk of AS occurrence in TMD patients with comorbidity, including parapsoriasis, rheumatoid arthritis, osteoporosis, Cushing’s syndrome, and climacteric arthritis (P < 0.012).

Conclusions

AS appears to significantly impact the occurrence of TMD. TMD might play a synergic role in AS development.

Clinical relevance

Clinicians have to be vigilant about the increased risk of TMD in AS patients and take care of AS disease activity and prognosis. The symptoms and signs of TMD could be a predictor of AS in patients with the aforementioned comorbidities.

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Funding

This study is supported in part by the Ministry of Health and Welfare, Taiwan (MOHW109-TDU-B-212-114004), MOST Clinical Trial Consortium for Stroke (MOST 108-2321-B-039-003), China Medical University Hospital (DMR-109-126), Chang Gung Memorial Hospital (CMRPG3I0152), Far Eastern Memorial Hospital (FEMH-2021-C-051), and Tseng-Lien Lin Foundation, Taichung, Taiwan.

Author information

Authors and Affiliations

  1. Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan

    Yi-Fang Huang

  2. School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan

    Yi-Fang Huang & Chung-Ta Chang

  3. Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan

    Yi-Fang Huang

  4. Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist, New Taipei City, 22056, Taiwan

    Chung-Ta Chang

  5. Graduate Institute of Medicine, Yuan Ze University, Taoyuan, 32003, Taiwan

    Chung-Ta Chang

  6. Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan

    Chih-Hsin Muo

  7. Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City, 22056, Taiwan

    Kuan-Ming Chiu

  8. Department of Nursing, Oriental Institute of Technology, New Taipei City, 22056, Taiwan

    Kuan-Ming Chiu

  9. Department of Electrical Engineering, Yuan Ze University, Taoyuan, 32003, Taiwan

    Kuan-Ming Chiu

  10. Department of Orthopedics, China Medical University Hospital, Taichung, 40402, Taiwan

    Chun-Hao Tsai

  11. Graduate Institute of Clinical Medicine, China Medical University, Taichung, 40402, Taiwan

    Chun-Hao Tsai

  12. Program for Aging, College of Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung, 40402, Taiwan

    Shih-Ping Liu

  13. Center for Translational Medicine, China Medical University and Hospital, Taichung, 40402, Taiwan

    Shih-Ping Liu

  14. Department of Social Work, Asia University, Taichung, 41354, Taiwan

    Shih-Ping Liu

Authors
  1. Yi-Fang Huang
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  2. Chung-Ta Chang
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  3. Chih-Hsin Muo
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  4. Kuan-Ming Chiu
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  5. Chun-Hao Tsai
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  6. Shih-Ping Liu
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Corresponding authors

Correspondence to Chung-Ta Chang or Shih-Ping Liu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Research Ethics Committee of China Medical University and Hospital, Taiwan, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare no competing interests.

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Huang, YF., Chang, CT., Muo, CH. et al. Bidirectional relationship between temporomandibular disorder and ankylosing spondylitis: a population-based cohort study. Clin Oral Invest 25, 6377–6384 (2021). https://doi.org/10.1007/s00784-021-03938-0

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  • DOI: https://doi.org/10.1007/s00784-021-03938-0

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