Ethnic Variations in Temporomandibular Disorder Symptoms, Oral Behaviours, Personality Traits, and Psychosocial Profiles Among Young Adults: Insights From a Comparative Analysis

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BACKGROUND: Although psychosocial and behavioural factors in temporomandibular disorders (TMDs) are well documented, ethnic variations remain underexplored, particularly within multiracial populations. OBJECTIVES: This study aimed to compare TMD symptoms, oral behaviours, and psychosocial characteristics across ethnic groups, examine interrelationships between physical-psychosocial variables, and identify factors influencing TMD pain and oral behaviours in young adults. METHODS: Participants, recruited from a large public university, completed an online survey comprising sociodemographic information, the Five TMD Symptoms screener, Short-form Fonseca Anamnestic Index, Oral Behaviour Checklist, Big-Five Personality Inventory-10, Patient Health Questionnaire-4, and 15. Data were evaluated using the Chi-square test, non-parametric tests/correlation, and logistic regression (α = 0.05). RESULTS: The study included 766 individuals (mean age: 21.1 [SD 1.8]; 65.8% women) with an ethnic distribution of 58.4% Malay (M), 36.2% Chinese (C), and 5.5% Indian (I). Of these, 34.1% reported no TMD symptoms, while 8.5%, 29.1%, and 28.3% had intra-articular, pain-related, and combined symptoms, respectively. Moderate-to-severe psychological distress affected 21.3%, and 16.6% experienced moderate-to-severe somatization. No significant differences were found in TMD symptom type/severity or frequency of oral behaviours. However, notable variations in personality traits, psychological distress (I/M > C; p = 0.018), and somatization (M > C; p = 0.001) were observed among the three ethnic groups. Moderate correlations were detected between oral behaviours, psychological distress, and somatization (rs = 0.42-0.53). CONCLUSIONS: In young adults, both TMD pain and high oral overuse behaviour are linked to psychological distress (ORs < 1.19) and somatization (ORs < 1.14). Ethnicity was not independently associated but may still hold relevance in multicultural contexts.

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