Association Between Gastroesophageal Reflux Symptoms and Temporomandibular Disorders in Healthcare Professionals: The Role of Shift Work, Oral Parafunctions, and Psychological Distress
Journal of Clinical Medicine, cilt.15, sa.13, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 13
- Basım Tarihi: 2026
- Doi Numarası: 10.3390/jcm15135304
- Dergi Adı: Journal of Clinical Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: GERD, oral parafunction, psychological stress, shift work, temporomandibular disorder
- Kocaeli Üniversitesi Adresli: Evet
Özet
Background/Objectives: Shift work is associated with circadian disruption, sleep disturbances, and psychological distress, all of which may influence both reflux-related symptoms and temporomandibular disorder (TMD)-related complaints. However, the relationships among reflux-related symptom burden, TMD severity, oral parafunctional behaviors, and psychological distress in healthcare professionals remain insufficiently understood. To evaluate the association between reflux-related symptom burden, assessed using the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) questionnaire, and TMD severity among healthcare professionals, and to investigate the potential roles of shift work, oral parafunctional behaviors, and psychological distress in this relationship. Methods: This cross-sectional observational study included healthcare professionals working at a tertiary hospital. Data were collected using validated questionnaires, including the GERD-HRQL, Fonseca Anamnestic Index, Oral Behavior Checklist (OBC), Depression Anxiety Stress Scale-21 (DASS-21), and Epworth Sleepiness Scale (ESS). Participants were categorized as shift workers (≥4 night shifts/month) and non-shift workers. Correlation and multivariable regression analyses were performed. Results: A total of 240 participants were included. Higher GERD-HRQL scores were positively correlated with TMD severity (r = 0.31, 95% CI: 0.19 to 0.42, p < 0.001), oral parafunctional behavior scores (r = 0.28, 95% CI: 0.16 to 0.39, p < 0.001), and DASS-21 stress scores (r = 0.35, 95% CI: 0.23 to 0.46, p < 0.001). Shift workers demonstrated significantly higher GERD-HRQL scores and TMD severity scores than non-shift workers, with small-to-moderate effect sizes. In multivariable analysis, higher TMD severity, OBC score, stress score, and shift-work exposure showed adjusted associations with higher GERD-HRQL scores. The model explained 32% of the variance in reflux-related symptom burden (R2 = 0.32; adjusted R2 = 0.29). Conclusions: Higher GERD-HRQL scores, reflecting reflux-related symptom burden rather than objectively confirmed GERD, showed weak to small-to-moderate associations with TMD severity, oral parafunctional behaviors, psychological distress, and shift-work exposure among healthcare professionals. These findings indicate co-occurrence of gastrointestinal, temporomandibular, behavioral, and psychosocial symptom domains within this occupational population. Longitudinal studies using objective diagnostic methods are required to clarify the directionality and clinical significance of these associations.