Association between temporomandibular symptoms, anxiety and quality of life among nursing students

Document Type

Journal Article


Elsevier Ltd


School of Nursing and Midwifery


Originally published as: Mortimer-Jones, S., Stomski, N., Cope, V., Maurice, L., & Théroux, J. (2019). Association between temporomandibular symptoms, anxiety and quality of life among nursing students. Collegian, 26(3), 373-377. Original publication available here



Anxiety is inherent in the everyday life of a nursing student. One of the physiological disorders associated with anxiety is temporomandibular disorder (TMD). Although the relationship between TMD and anxiety is well established, temporomandibular-related symptoms in nursing students has yet to be examined.


To investigate the association between anxiety and temporomandibular-related symptoms in nursing students, and the effect on quality of life.


281 nursing students completed an online survey that included the Oral Health Impact Profile-TMD (OHIP-TMD) questionnaire and the Patient-Reported Outcome Measurement Information System (PROMIS) short form questionnaire. The OHIP-TMD psychometric properties were assessed using principal component analysis. Linear regression models were used to examine demographic predictors for anxiety and TMD, and a general linear model was used to assess the association between anxiety and the psychosocial and function scales.


The mean value for the OHIP-TMD and the PROMIS short form was respectively 1.6 (SD = 0.7) and 10.8 (SD = 4.1). Linear regression demonstrated that there was an inverse association between oral related quality of life and year of study; nursing students in higher course years reported lower levels of oral related quality of life. The general linear model analysis revealed that increased anxiety was significantly associated with high levels of oral physical function impairment and elevated psychosocial distress.


With TMD reported as frequent among qualified nurses these findings are relevant and pave the way for further investigation of temporomandibular-related symptoms in nursing students.


Strategies to mitigate students’ anxiety levels should be implemented throughout the nursing course.