Symptomatic gastroesophageal reflux disease (GERD) is associated with chronic temporomandibular disorder (TMD), and the correlation is partially mediated by somatization, anxiety, and undermined sleep, according to a study published online Aug. 19 in CMAJ, the journal of the Canadian Medical Association.

Yuanyuan Li, D.D.S., from The Fourth Military Medical University in Xi'an, China, and colleagues conducted a case-control study involving 1,522 consecutive adult patients with chronic TMD and 1,522 matched controls. Participants were aged 18 to 70 years; recruitment occurred from July 2017 to April 2018. The correlation between chronic TMD and GERD was assessed. Validated questionnaires were used to evaluate psychological status and sleep quality and to determine their potential mediating effects on the correlation.

The researchers identified 132 patients and 61 controls with GERD. GERD was identified as a risk factor for TMD using conditional logistic regression analysis (odds ratio, 2.74). Somatization, anxiety, and undermined sleep moderately mediated the correlation between TMD and GERD in mediation analyses.

"Physicians and patients may overlook the association between chronic musculoskeletal diseases and gastrointestinal symptoms," the authors write. "Patients with both chronic TMD and reflux symptoms may be underdiagnosed, resulting in deferred effective treatment and a prolonged disease course."

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