{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:39:25Z","timestamp":1792348765174,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp;amp; Exp Dental Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine associations between temporomandibular disorder (TMD)\u2010related symptoms, psychological distress, and sleep quality among hospital healthcare staff, and to explore whether cumulative psychological\u2013sleep burden was associated with pain\u2010related TMD in a graded pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included 193 healthcare employees from a tertiary public hospital in Beijing, China. TMD\u2010related symptoms were assessed using self\u2010reported symptom items from the Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) Symptom Questionnaire for symptom screening rather than definitive clinical diagnosis. Psychological distress was measured using the Depression Anxiety Stress Scales\u201321 (DASS\u201021), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). An exploratory psychological\u2013sleep composite burden index was constructed by summing standardized depression, anxiety, stress, and global PSQI scores. Multivariable logistic regression models evaluated associations between the composite index and pain\u2010related TMD, adjusting for age group, sex, and occupational role. Quartile\u2010based trend and sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pain\u2010related TMD was reported by 67 participants (34.7%). Each 1\u2010SD increase in the composite index showed a positive but borderline association with pain\u2010related TMD (adjusted OR\u2009=\u20091.36, 95% CI: 1.00\u20131.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.052). In quartile\u2010based analysis, each higher burden quartile was associated with increased odds of pain\u2010related TMD (adjusted OR\u2009=\u20091.37, 95% CI: 1.03\u20131.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030). After excluding headache\u2010only cases, the quartile\u2010based association remained significant (adjusted OR\u2009=\u20091.37, 95% CI: 1.02\u20131.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Symptom\u2010specific analyses showed heterogeneous patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher cumulative psychological\u2013sleep burden was associated with greater odds of pain\u2010related TMD among hospital healthcare staff, particularly in quartile\u2010based analyses. These findings support a cautious biopsychosocial interpretation and suggest that psychological distress and sleep quality may be relevant considerations in occupational oral health assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cre2.70428","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:39:36Z","timestamp":1792345176000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Temporomandibular Disorder\u2010Related Symptoms, Psychological Distress, and Sleep Quality Among Hospital Healthcare Staff"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1890-9690","authenticated-orcid":false,"given":"Xiang","family":"Bian","sequence":"first","affiliation":[{"name":"Department of Stomatology Beijing Xiaotangshan Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqiang","family":"Yan","sequence":"additional","affiliation":[{"name":"Beijing Open University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.11607\/ofph.2780"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093228"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.20.2433"},{"issue":"1","key":"e_1_2_12_5_1","first-page":"3","article-title":"Quality of Life in Patients With Temporomandibular Disorders: A Systematic Review","volume":"20","author":"Bitiniene D.","year":"2018","journal-title":"Stomatologija"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12661"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/08869634.2020.1861886"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.847460"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.06.009"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.08.007"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1590\/2176-9451.20.1.127-133.sar"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.133.4.581"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-019-0439-z"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.00247"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.09.004"},{"issue":"2","key":"e_1_2_12_17_1","first-page":"103","article-title":"Reliability and Validity of the Pittsburgh Sleep Quality Index","volume":"29","author":"Liu X. C.","year":"1996","journal-title":"Chinese Journal of Psychiatry"},{"key":"e_1_2_12_18_1","volume-title":"Manual for the Depression Anxiety Stress Scales","author":"Lovibond S. H.","year":"1995"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801153380307"},{"key":"e_1_2_12_20_1","volume-title":"Assessment of Psychological Factors in Orofacial Pain Patients: A Meta\u2010analysis","author":"Reese R. G.","year":"2003"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.11607\/jop.1151"},{"key":"e_1_2_12_22_1","volume-title":"Psychometric Properties of a Chinese Version of the 21\u2010Item Depression Anxiety Stress Scales (DASS21","author":"Taouk M.","year":"2001"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-005-4346-x"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-020-03710-w"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-025-01985-6"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000047881"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05336-0"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2009.05.059"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0318946"}],"container-title":["Clinical and Experimental Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cre2.70428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cre2.70428","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cre2.70428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:39:43Z","timestamp":1792345183000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cre2.70428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/cre2.70428"],"URL":"https:\/\/doi.org\/10.1002\/cre2.70428","archive":["Portico"],"relation":{},"ISSN":["2057-4347","2057-4347"],"issn-type":[{"value":"2057-4347","type":"print"},{"value":"2057-4347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-02-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70428"}}