Association of perceived stress, sleep quality, temporomandibular disorders, and oral health-related quality of life among dental students: a cross-sectional study

Abstract

Dental education is a stressful, demanding environment that may adversely affect various aspects of students’ health, including temporomandibular disorders (TMD), perceived stress, poor sleep, and oral health-related quality of life (OHRQoL). This study assessed the interrelationships among TMD, perceived stress, sleep quality, and OHRQoL among dental students. We conducted a cross-sectional study among 168 dental students at the College of Dentistry, Jazan University, Saudi Arabia. Participants completed the validated Arabic short versions of the Short Fonseca Anamnestic Index for TMD (SFAI-TMD) and the 5-item Oral Health Impact Profile (OHIP-5). They also completed study-adapted 4-item Perceived Stress Scale (PSS-4) and 6-item Pittsburgh Sleep Quality Index (PSQI-6) questionnaires derived from validated Arabic full-length instruments. We assessed associations between outcomes and participant characteristics using Mann–Whitney U and Kruskal–Wallis tests and examined correlations using Spearman’s correlation coefficient. The p-value was set at < 0.05. The mean scores were 16.97 ± 21.93 for SFAI-TMD, 7.44 ± 2.98 for OHIP-5, 12.02 ± 2.65 for PSS-4, and 6.58 ± 3.22 for PSQI-6. TMD symptoms were present in 44.8% of students, predominantly mild TMD. Significant positive correlations were observed between SFAI-TMD and OHIP-5 (r s =0.397), SFAI-TMD and PSQI-6 (r s =0.248), OHIP-5 and PSS-4 (r s =0.225), and PSS-4 and PSQI-6 (r s =0.293). Perceived stress was significantly higher among females and preclinical students. Poorer sleep quality was observed among smokers, while a history of oral and maxillofacial surgery was associated with higher TMD scores. TMD, perceived stress, sleep quality, and OHRQoL appear to be interconnected among dental students. Given these interconnections, these domains may be considered collectively rather than in isolation when planning screening and supportive interventions; however, further large-scale, well-designed studies are needed.

The authors' abstract, as published at the source. BMC Oral Health, 2026 · DOI ↗