{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:35:03Z","timestamp":1775709303024,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Studies on the role of physical fitness, physical activity and obesity as risk factors for temporomandibular disorders (TMD) are scarce. The aim of the present study was to evaluate the association of TMD symptoms with physical fitness, physical activity and body mass index (BMI) among Finnish conscripts. The study sample consisted of 8685 Finnish conscripts. Data on self-reported TMD symptoms were used as outcome variables. Physical activity (questionnaire), physical fitness (measured with physical tests: Cooper test, push-ups, sit-ups and standing long jump) and body mass index (BMI) were used as explanatory variables. The associations between TMD symptoms and explanatory variables were evaluated using Chi-squared test and logistic regression analysis. The prevalence of all TMD symptoms was significantly higher among those who exercised more rarely than weekly. Pain-related TMD symptoms were also significantly more frequent among those who were overweight (BMI \u2265 25). Poor push-up results and overweight (BMI \u2265 25) were significantly associated with jaw pain and TMJ pain at jaw rest. The present study showed that good physical fitness may be a protective factor against TMD pain. Dentists should also be prepared to motivate TMD patients to physical activity and regular exercise as part of the treatment.<\/jats:p>","DOI":"10.3390\/ijerph18063032","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T12:01:02Z","timestamp":1615896062000},"page":"3032","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Association of Temporomandibular Disorder Symptoms with Physical Fitness among Finnish Conscripts"],"prefix":"10.3390","volume":"18","author":[{"given":"Ossi","family":"Miettinen","sequence":"first","affiliation":[{"name":"Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4921-4045","authenticated-orcid":false,"given":"Antti","family":"K\u00e4mppi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5418-4798","authenticated-orcid":false,"given":"Tarja","family":"Tanner","sequence":"additional","affiliation":[{"name":"Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland"},{"name":"Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, P.O. Box 5281, 90014 Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vuokko","family":"Anttonen","sequence":"additional","affiliation":[{"name":"Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland"},{"name":"Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, P.O. Box 5281, 90014 Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pertti","family":"Patinen","sequence":"additional","affiliation":[{"name":"Centre for Military Medicine, Finnish Defense Forces, P.O. Box 10, 11311 Riihim\u00e4ki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7526-7648","authenticated-orcid":false,"given":"Jari","family":"P\u00e4kkil\u00e4","sequence":"additional","affiliation":[{"name":"Department of Mathematical Sciences, University of Oulu, P.O. Box 3000, 90014 Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Tj\u00e4derhane","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland"},{"name":"Helsinki University Hospital, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsi","family":"Sipil\u00e4","sequence":"additional","affiliation":[{"name":"Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland"},{"name":"Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, P.O. Box 5281, 90014 Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"ref_1","unstructured":"De Leeuw, R., and Klasser, G.D. (2013). Orofacial pain: Guidelines for assessment, diagnosis, and management. Diagnostic Classification of Orofacial Pain, Quintessence. [5th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic criteria for temporomandibular disorders (DC\/TMD) for clinical and research applications: Recommendations of the International RDC\/MTD Consortium Network and Orofacial Pain Special Interest Group","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_3","first-page":"208","article-title":"Occurrence of clinical signs of temporomandibular disorders in adult Finns","volume":"20","author":"Rutkiewicz","year":"2006","journal-title":"J. Orofac. Pain"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"159","DOI":"10.11607\/ofph.1773","article-title":"Prevalence of Temporomandibular Disorders in the Northern Finland Birth Cohort 1966","volume":"31","author":"Jussila","year":"2017","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/joor.12759","article-title":"Prevalence and treatment strategies regarding temporomandibular disorders in children and adolescents\u2014A systematic review","volume":"46","author":"Christidis","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1080\/00016357.2020.1746395","article-title":"Prevalence of clinical signs and pain symptoms of temporomandibular disorders and associated factors in adult Finns","volume":"78","author":"Qvintus","year":"2020","journal-title":"Acta Odontol. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"30","DOI":"10.11607\/ofph.1595","article-title":"Prevalence of Temporomandibular Disorder Symptoms and Their Association with Alcohol and Smoking Habits","volume":"31","author":"Miettinen","year":"2017","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_8","unstructured":"Okeson, J.P. (2019). Management of Temporomandibular Disorders and Occlusion, Elsevier. [8th ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.ynpai.2017.04.003","article-title":"A new aspect of chronic pain as a lifestyle-related disease","volume":"1","author":"Senba","year":"2017","journal-title":"Neurobiol. Pain"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.pain.2013.01.014","article-title":"Preclinical episodes of orofacial pain symptoms and their association with health care behaviors in the OPPERA prospective cohort study","volume":"154","author":"Slade","year":"2013","journal-title":"Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/00016350410001649","article-title":"Associations between social and general health factors and symptoms related to temporomandibular disorders and bruxism in a population of 50-year-old subjects","volume":"62","author":"Johansson","year":"2004","journal-title":"Acta Odontol. Scand."},{"key":"ref_12","first-page":"73","article-title":"Painful temporomandibular disorders and headaches in 359 dental and medical students","volume":"42","author":"Benoliel","year":"2011","journal-title":"Quintessence Int"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/joor.12771","article-title":"Obesity, sedentarism and TMD-pain in adolescents","volume":"46","author":"Jordani","year":"2019","journal-title":"Oral Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.jcms.2016.04.016","article-title":"Association between temporomandibular disorders and obesity","volume":"44","author":"Rhim","year":"2016","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_15","first-page":"455","article-title":"Endurance to physical strain in patients with temporomandibular disorders: A case-control study","volume":"70","year":"2011","journal-title":"Acta Odontol. Scand."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.jpain.2016.03.011","article-title":"Associations of Sedentary Behavior, Physical Activity, Cardiorespiratory Fitness, and Body Fat Content With Pain Conditions in Children: The Physical Activity and Nutrition in Children Study","volume":"17","author":"Vierola","year":"2016","journal-title":"J. Pain"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1600-0838.2007.00672.x","article-title":"Associations of physical activity and inactivity with low back pain in adolescents","volume":"18","author":"Auvinen","year":"2007","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"106","DOI":"10.4103\/2155-8213.103928","article-title":"A methodological pilot study on oral health of young, healthy males","volume":"3","author":"Anttonen","year":"2012","journal-title":"Dent. Hypotheses"},{"key":"ref_19","unstructured":"Pihlainen, K., Ohrank\u00e4mmen, O., and Ilom\u00e4ki, J. (2011). Puolustusvoimien Kuntotestaajan K\u00e4sikirja, Edita Prima. [2nd ed.]."},{"key":"ref_20","unstructured":"American College of Sports Medicine (2000). ACSM\u2019s Guidelines for Exercise Testing and Prescription, Lippincott Williams & Wilkins. [6th ed.]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1001\/jama.1968.03140030033008","article-title":"A means of assessing maximal oxygen intake. Correlation between field and treadmill testing","volume":"203","author":"Cooper","year":"1968","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1161\/01.CIR.86.1.340","article-title":"Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart association","volume":"86","author":"Fletcher","year":"1992","journal-title":"Circulation"},{"key":"ref_23","unstructured":"(2021, March 01). Available online: https:\/\/www.who.int\/activities\/preventing-noncommunicable-diseases\/."},{"key":"ref_24","unstructured":"(2021, March 01). Available online: https:\/\/health.gov\/our-work\/physical-activity."},{"key":"ref_25","unstructured":"(2021, March 01). Available online: https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/topic-details\/GHO\/ncd-risk-factors."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1123\/jpah.2018-0675","article-title":"Effects of Physical Activity on the Physical and Psychosocial Health of Youth with Intellectual Disabilities: A Systematic Review and Meta-Analysis","volume":"16","author":"Kapsal","year":"2019","journal-title":"J. Phys. Act. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.ejpain.2005.01.012","article-title":"Review of aetiological concepts of temporomandibular pain disorders: Towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors","volume":"9","author":"Suvinen","year":"2005","journal-title":"Eur. J. Pain"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1007\/s11926-011-0204-8","article-title":"Do sleep disorders contribute to pain sensitivity?","volume":"13","author":"Okifuji","year":"2011","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1080\/00016357.2017.1373304","article-title":"The effect of supervised exercise on localized TMD pain and TMD pain asociated with generalized pain","volume":"76","author":"Wiesinger","year":"2018","journal-title":"Acta Odontol. Scand."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"T93","DOI":"10.1016\/j.jpain.2016.06.002","article-title":"Overlapping Chronic Pain Conditions: Implications for Diagnosis and Classification","volume":"17","author":"Maixner","year":"2016","journal-title":"J. Pain"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1097\/j.pain.0000000000001348","article-title":"Long-term changes in biopsychosocial characteristics related to temporomandibular disorder: Findings from the OPPERA study","volume":"159","author":"Fillingim","year":"2018","journal-title":"Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/joor.12771","article-title":"Obesity, sedentarism and TMD-pain in adolescents","volume":"46","author":"Jordani","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_33","first-page":"111","article-title":"Chapter 5 Proinflammatory cytokines in CRP baseline regulation","volume":"48","author":"Eklund","year":"2009","journal-title":"Adv. Appl. Microbiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1080\/00016357.2019.1650955","article-title":"Factors associated with signs of temporomandibular pain: An 11-year-follow-up study on Finnish adults","volume":"78","author":"Banafa","year":"2019","journal-title":"Acta Odontol. Scand."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1080\/08869634.2002.11746206","article-title":"Temporomandibular Disorders, Occlusion, and Neck Pain in Subjects with Facial Pain: A Case-Control Study","volume":"20","author":"Zitting","year":"2002","journal-title":"CRANIO\u00ae\u00ae"},{"key":"ref_36","unstructured":"Siilasmaa, R., Ahtisaari, M., Ala-Pietil\u00e4, P., and Finnish Military Service (2016, October 28). Helsinki: Ministry of Defense. Available online: http:\/\/www.defmin.fi\/files\/1648\/Suomalainen_asevelvollisuus_plmv2_2010.pdf."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.3109\/00016357.2014.949843","article-title":"Associations between craniomandibular disorders, sociodemographic factors and self-perceived general and oral health in an adult population","volume":"72","author":"Yekkalem","year":"2014","journal-title":"Acta Odontol. Scand."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1177\/0269215516672275","article-title":"The effectiveness of exercise therapy for temporomandibular dysfunction: A systematic review and meta-analysis","volume":"31","author":"Dickerson","year":"2017","journal-title":"Clin. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2522\/ptj.20140548","article-title":"Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis","volume":"96","author":"Pitance","year":"2016","journal-title":"Phys. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"389","DOI":"10.11607\/ofph.2359","article-title":"Jaw Exercises in the Treatment of Temporomandibular Disorders\u2014An International Modified Delphi Study","volume":"39","author":"Lindfors","year":"2019","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1080\/00016357.2019.1598573","article-title":"Patients\u2019 experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain","volume":"77","author":"Mienna","year":"2019","journal-title":"Acta Odontol. Scand."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/6\/3032\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:36:15Z","timestamp":1760160975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/6\/3032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,16]]},"references-count":41,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["ijerph18063032"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18063032","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,16]]}}}