{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:17:13Z","timestamp":1792275433169,"version":"4.4.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To investigate the relationship between Temporomandibular disorder (TMD) and associated comorbidities in groups matched according to age and sex.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using data from the cross-sectional fifth Korea National Health and Nutrition Examination Survey (KNHANES). Of the 25,534 eligible KNHANES, 17,762 adults aged \u226519 years who responded to survey questionnaire on TMD and comorbidities. Subjects were classified into eight groups according to age and sex. Logistic regression analyses were performed to evaluate the association between TMD and comorbidities according to age and sex.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the enrolled participants, 2,107 (11.86%) complained of \u22651 TMD symptoms. In all groups, odds ratios (ORs) for prevalence of TMD were &gt;1 in those with tinnitus. Rhinitis was closely associated with TMD in 6 groups. ORs for TMD with comorbidities according to age and sex were as follows: hypertension, men aged 50\u201364 years (OR 0.62; CI 0.41\u20130.94); ischemic heart disease, men aged 35\u201349 years (4.38; 1.54\u201312.47); osteoarthritis, women aged 50\u201364 years (1.38; 1.03\u20131.86); diabetes mellitus, men aged 35\u201349 years (0.21; 0.05\u20130.88); depression, men aged 50\u201364 years (1.68; 1.00\u20132.83), women aged 35\u201349 years (1.39; 1.05\u20131.85) and women aged 65\u201380 years (2.01; 1.46\u20132.77); migraine, men aged 50\u201364 years (1.60; 1.14\u20132.25), women aged d35-49 years (1.44; 1.14\u20131.81) and women aged 35\u201349 years (1.43; 1.07\u20131.90); cold hypersensitivity in the hands and feet, men aged 19\u201334 years (1.64; 1.05\u20132.58), men aged 35\u201349 years (1.68; 1.04\u20132.70), men aged 65\u201380 years (1.74; 1.09\u20132.75) and women aged 35\u201349 years (1.45; 1.15\u20131.84); olfaction disorder, men aged 50\u201364 years (2.49; 1.39\u20134.43); voice disorder, men aged 50\u201364 years (2.25; 1.28\u20133.96) and women aged 65\u201380 years (1.69; 1.09\u20132.63)<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study confirmed that the types and effects of comorbidities related to prevalence of TMD may differ according to the patient\u2019s age and sex and this result will increase the predictability of the onset of TMD.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0296378","type":"journal-article","created":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T19:32:21Z","timestamp":1704223941000},"page":"e0296378","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Age and sex differences in comorbidities in adult temporomandibular disorders: A cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES)"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6918-1562","authenticated-orcid":true,"given":"Hye-Ji","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q-Schick","family":"Auh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,1,2]]},"reference":[{"issue":"20","key":"pone.0296378.ref001","doi-asserted-by":"crossref","first-page":"12164","DOI":"10.3390\/ijms232012164","article-title":"Pain management and rehabilitation for central sensitization in temporomandibular disorders: a comprehensive review","volume":"23","author":"M. Ferrillo","year":"2022","journal-title":"International Journal of Molecular Sciences"},{"key":"pone.0296378.ref002","volume-title":"Management of temporomandibular disorders and occlusion-E-book","author":"J.P. Okeson","year":"2019"},{"issue":"1","key":"pone.0296378.ref003","doi-asserted-by":"crossref","DOI":"10.5935\/2595-0118.20220003","article-title":"Comorbidities associated with temporomandibular joint disorders and the role of central sensitization: literature review","volume":"5","author":"H.N. Concei\u00e7\u00e3o","year":"2022","journal-title":"Brazilian Journal Of Pain"},{"issue":"6","key":"pone.0296378.ref004","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/joor.13446","article-title":"Prevalence of temporomandibular disorders in children and adolescents evaluated with Diagnostic Criteria for Temporomandibular Disorders: A systematic review with meta\u2010analysis","volume":"50","author":"G. Minervini","year":"2023","journal-title":"Journal of Oral Rehabilitation"},{"issue":"7","key":"pone.0296378.ref005","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/joor.13458","article-title":"Prevalence of temporomandibular disorders (TMD) in pregnancy: A systematic review with meta-analysis","volume":"50","author":"G. Minervini","year":"2023","journal-title":"Journal of Oral Rehabilitation"},{"issue":"5","key":"pone.0296378.ref006","doi-asserted-by":"crossref","first-page":"739","DOI":"10.13065\/jksdh.2013.13.05.739","article-title":"Association between psychological factors and temporomandibular disorders in Korean adults: The fouth Korean national health and nutritional examination survey (2009)","volume":"13","author":"S.-H. Sim","year":"2013","journal-title":"Journal of Korean Society of Dental Hygiene"},{"issue":"8","key":"pone.0296378.ref007","doi-asserted-by":"crossref","first-page":"3821","DOI":"10.3390\/app12083821","article-title":"Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized Controlled Trial","volume":"12","author":"N. Marotta","year":"2022","journal-title":"Applied Sciences"},{"issue":"1","key":"pone.0296378.ref008","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/joor.12457","article-title":"Association between temporomandibular disorders and pain in other regions of the body","volume":"44","author":"L.L. Bonato","year":"2017","journal-title":"Journal of oral rehabilitation"},{"issue":"10","key":"pone.0296378.ref009","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1177\/0022034516653743","article-title":"Painful temporomandibular disorder: decade of discovery from OPPERA studies","volume":"95","author":"G. Slade","year":"2016","journal-title":"Journal of dental research"},{"issue":"4","key":"pone.0296378.ref010","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.tripleo.2011.04.021","article-title":"Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings","volume":"112","author":"D. Manfredini","year":"2011","journal-title":"Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology"},{"issue":"5","key":"pone.0296378.ref011","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jdent.2010.01.006","article-title":"Age peaks of different RDC\/TMD diagnoses in a patient population","volume":"38","author":"D. Manfredini","year":"2010","journal-title":"Journal of dentistry"},{"issue":"6","key":"pone.0296378.ref012","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.7465\/jkdi.2015.26.6.1317","article-title":"Clinical data analysis in retrospective study through equality adjustment between groups","volume":"26","author":"S.G. Kwak","year":"2015","journal-title":"Journal of the Korean Data and Information Science Society"},{"key":"pone.0296378.ref013","unstructured":"\uae40\uc131\uc544 and \uc815\ud574\uc2dd, \uc5f0\ub839\ub300\ubcc4 \uc0b6\uc758 \ub9cc\uc871 \uc601\ud5a5\uc694\uc778 \ubd84\uc11d\uacfc \uc815\ucc45 \uacfc\uc81c. \ubcf4\uac74\ubcf5\uc9c0\ud3ec\ub7fc, 2019. 2019(4): p. 95\u2013104."},{"key":"pone.0296378.ref014","volume-title":"Oral health surveys: basic methods","author":"Organization, W.H.","year":"2013"},{"issue":"11","key":"pone.0296378.ref015","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/joor.13370","article-title":"The contribution of autonomic mechanisms to pain in temporomandibular disorders: A narrative review","volume":"49","author":"B.E. Cairns","year":"2022","journal-title":"Journal of Oral Rehabilitation"},{"issue":"6","key":"pone.0296378.ref016","first-page":"e005375","article-title":"Mortality from ischemic heart disease: Analysis of data from the World Health Organization and coronary artery disease risk factors From NCD Risk Factor Collaboration","volume":"12","author":"A.N. Nowbar","year":"2019","journal-title":"Circulation: cardiovascular quality and outcomes"},{"issue":"1","key":"pone.0296378.ref017","doi-asserted-by":"crossref","first-page":"74","DOI":"10.14219\/jada.archive.2007.0024","article-title":"Craniofacial pain as the sole symptom of cardiac ischemia: a prospective multicenter study","volume":"138","author":"M. Kreiner","year":"2007","journal-title":"The Journal of the American Dental Association"},{"issue":"6","key":"pone.0296378.ref018","first-page":"1","article-title":"Bilateral temporomandibular joint pain as the first and only symptom of ischemic cardiac disease: a case report.","volume":"34","author":"M. Dalband","year":"2011","journal-title":"Chang Gung Med J"},{"key":"pone.0296378.ref019","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.3949\/ccjm.74.Suppl_1.S30","article-title":"Neurological mechanisms of chest pain and cardiac disease","volume":"74","author":"R.D. Foreman","year":"2007","journal-title":"Cleveland Clinic journal of medicine"},{"issue":"3","key":"pone.0296378.ref020","first-page":"190","article-title":"Temporomandibular joint and muscle disorder (TMJMD)-type pain and co-morbid pains in a national US sample","volume":"25","author":"O. Plesh","year":"2011","journal-title":"Journal of orofacial pain"},{"key":"pone.0296378.ref021","volume-title":"Evidence for TMJ Pain As a Component of a Generalized Pain Phenotype. in ARTHRITIS & RHEUMATOLOGY","author":"J. Trost","year":"2016"},{"issue":"2","key":"pone.0296378.ref022","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/idj.12262","article-title":"Symptoms and signs of temporomandibular disorders in patients with knee osteoarthritis","volume":"67","author":"X. Zhang","year":"2017","journal-title":"International Dental Journal"},{"key":"pone.0296378.ref023","first-page":"18442","article-title":"Similarities and differences of estrogen in the regulation of temporomandibular joint osteoarthritis and knee osteoarthritis","author":"Y. Tian","year":"2022","journal-title":"Histol Histopathol"},{"issue":"4","key":"pone.0296378.ref024","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1089\/humc.2019.101","article-title":"Inhibition of miR-203 Ameliorates Osteoarthritis Cartilage Degradation in the Postmenopausal Rat Model: Involvement of Estrogen Receptor alpha","volume":"30","author":"L. Tian","year":"2019","journal-title":"Hum Gene Ther Clin Dev"},{"issue":"1","key":"pone.0296378.ref025","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1038\/s41467-017-01868-8","article-title":"Estrogen-related receptor gamma causes osteoarthritis by upregulating extracellular matrix-degrading enzymes","volume":"8","author":"Y.O. Son","year":"2017","journal-title":"Nat Commun"},{"key":"pone.0296378.ref026","doi-asserted-by":"crossref","first-page":"115123","DOI":"10.1016\/j.bone.2019.115123","article-title":"The effect of oestrogen on mandibular condylar cartilage via hypoxia-inducible factor-2alpha during osteoarthritis development","volume":"130","author":"T. Ye","year":"2020","journal-title":"Bone"},{"issue":"4","key":"pone.0296378.ref027","doi-asserted-by":"crossref","first-page":"399","DOI":"10.11607\/ofph.2213","article-title":"Association between temporomandibular disorders pain and migraine: results of the health 2000 Survey","volume":"33","author":"J. Ashraf","year":"2019","journal-title":"J Oral Facial Pain Headache"},{"issue":"3","key":"pone.0296378.ref028","article-title":"Temporomandibular Disorders and Headache","volume":"28","author":"S.B. Graff-Radford","year":"2016","journal-title":"Oral and Maxillofacial Surgery Clinics of North America"},{"issue":"4","key":"pone.0296378.ref029","doi-asserted-by":"crossref","first-page":"325","DOI":"10.11607\/jop.1096","article-title":"Treatment of comorbid migraine and temporomandibular disorders: a factorial, double-blind, randomized, placebo-controlled study","volume":"27","author":"D. Goncalves","year":"2013","journal-title":"J Orofac Pain"},{"issue":"12","key":"pone.0296378.ref030","doi-asserted-by":"crossref","first-page":"T51","DOI":"10.1016\/j.jpain.2013.06.001","article-title":"General health status and incidence of first-onset temporomandibular disorder: the OPPERA prospective cohort study","volume":"14","author":"A.E. Sanders","year":"2013","journal-title":"The Journal of Pain"},{"key":"pone.0296378.ref031","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/head.12515","article-title":"Temporomandibular dysfunction and headache disorder","author":"J.G. Speciali","year":"2015","journal-title":"Headache: The Journal of Head and Face Pain"},{"issue":"10","key":"pone.0296378.ref032","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1111\/joor.12693","article-title":"Autonomic responses to tooth clenching in migraineurs-augmented trigeminocardiac reflex?","volume":"45","author":"N. Zaproudina","year":"2018","journal-title":"J Oral Rehabil"},{"issue":"24","key":"pone.0296378.ref033","doi-asserted-by":"crossref","first-page":"5555","DOI":"10.1111\/bph.15263","article-title":"Preclinical studies investigating the neural mechanisms involved in the co-morbidity of migraine and temporomandibular disorders: the role of CGRP","volume":"177","author":"S. Akerman","year":"2020","journal-title":"British Journal of Pharmacology"},{"issue":"2","key":"pone.0296378.ref034","doi-asserted-by":"crossref","first-page":"64","DOI":"10.13048\/jkm.18016","article-title":"A Study of Clinical Characteristics of Female Patients with Cold Hypersensitivity on Hands and Feet.","volume":"39","author":"J.-Y. Kwon","year":"2018","journal-title":"The Journal of Korean Medicine"},{"issue":"6","key":"pone.0296378.ref035","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1265\/jjh.49.1004","article-title":"Relationship between chilliness of the limbs and daily-life conditions in young females","volume":"49","author":"N. MIYAMOTO","year":"1995","journal-title":"Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene)"},{"issue":"1","key":"pone.0296378.ref036","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1515\/cipms-2015-0044","article-title":"Psychological aspects of temporomandibular disorders-literature review","volume":"28","author":"M. Berger","year":"2015","journal-title":"Current Issues in Pharmacy and Medical Sciences"},{"issue":"4","key":"pone.0296378.ref037","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/joor.12367","article-title":"A systematic review of the comorbidity between Temporomandibular Disorders and Chronic Fatigue Syndrome","volume":"43","author":"L.J. Robinson","year":"2016","journal-title":"Journal of Oral Rehabilitation"},{"issue":"4","key":"pone.0296378.ref038","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1080\/13548506.2021.1908571","article-title":"Stress and emotional distress: their associations with somatic and temporomandibular disorder-related symptoms","volume":"27","author":"A.U. Yap","year":"2022","journal-title":"Psychology, health & medicine"},{"key":"pone.0296378.ref039","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/7020751","article-title":"Temporomandibular disorders related to stress and HPA-axis regulation","volume":"2018","author":"K. Staniszewski","year":"2018","journal-title":"Pain Research and Management"},{"key":"pone.0296378.ref040","doi-asserted-by":"crossref","first-page":"104599","DOI":"10.1016\/j.psyneuen.2020.104599","article-title":"Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence","volume":"114","author":"A.I. Turner","year":"2020","journal-title":"Psychoneuroendocrinology"},{"issue":"10","key":"pone.0296378.ref041","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/j.1365-2842.2012.02320.x","article-title":"Psychometric features of temporomandibular disorders patients in relation to pain diffusion, location, intensity and duration","volume":"39","author":"L. Guarda\u2010Nardini","year":"2012","journal-title":"Journal of oral rehabilitation"},{"key":"pone.0296378.ref042","doi-asserted-by":"crossref","first-page":"s73","DOI":"10.11607\/ofph.2577","article-title":"Associations of sleep disturbance, atopy, and other health measures with chronic overlapping pain conditions","volume":"34","author":"A.E. Sanders","year":"2020","journal-title":"J Oral Facial pain headache"},{"issue":"6","key":"pone.0296378.ref043","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/j.oooo.2013.02.014","article-title":"Orofacial pain and sensory characteristics of chronic patients compared with controls","volume":"115","author":"S.R.D.T. de Siqueira","year":"2013","journal-title":"Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology,"},{"issue":"11","key":"pone.0296378.ref044","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/j.1365-2842.2009.01996.x","article-title":"Self\u2010reported severity of taste disturbances correlates with dysfunctional grade of TMD pain","volume":"36","author":"D.R. Nixdorf","year":"2009","journal-title":"Journal of oral rehabilitation"},{"issue":"3","key":"pone.0296378.ref045","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ijpsycho.2007.03.007","article-title":"Interactions between the chemical senses: trigeminal function in patients with olfactory loss","volume":"65","author":"J. Frasnelli","year":"2007","journal-title":"International Journal of Psychophysiology"},{"issue":"6","key":"pone.0296378.ref046","doi-asserted-by":"crossref","first-page":"841. e17","DOI":"10.1016\/j.jvoice.2014.04.001","article-title":"Voice-related disability of Iranian patients with temporomandibular disorders","volume":"28","author":"N. Moradi","year":"2014","journal-title":"Journal of Voice"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296378","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T19:32:49Z","timestamp":1704223969000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296378"}},"subtitle":[],"editor":[{"given":"Martina","family":"Ferrillo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,1,2]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0296378","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,2]]}}}