Skip to main content

Refine your search

Käsi leualla.

Doctoral defence of Aisha Banafa, BDS, 20 Oct 2023: Various biopsychosocial risk factors linked to temporomandibular pain

The doctoral dissertation in the field of Stomatognathic Physiology will be examined at the Faculty of Health Sciences at Kuopio campus. The public examination will be streamed online.

What is the topic of your doctoral research? Why is it important to study the topic?

The study investigated how different biological, social, and psychological risk factors can interact to increase the risk of pain in the jaw's muscles and joints in Finnish adults. The study explored the association of sociodemographic background, low-grade inflammation, depressive symptoms, somatization symptoms, and cynicism with the temporomandibular pain disorders (pain in the muscles of mastication and joints of the jaw), as well as the interactions between those risk factors to increase the risk of temporomandibular pain disorders in an 11-year follow-up. The etiology of temporomandibular pain disorders is complex and not fully understood, which makes it difficult to attribute the pain to a single isolated factor.

What are the key findings or observations of your doctoral research?

Women, people with lower educational level, and those with previous pain experience in the masticatory muscles showed a higher risk of chronic pain 11 years later.

Low-grade inflammation 11 years prior increased the risk of chronic temporomandibular pain disorders 11 years after in men with chronic illness.

Higher depressive symptoms level 11 years prior increased the risk of chronic pain 11 years after in men with chronic illness, however the risk of chronic pain in women was independent of chronic illness.

Adults with higher levels of cynical hostility 11 years prior showed an increased risk of chronic pain, that risk was mediated through increases in depressive and somatization symptoms.

To our knowledge this is the first study to investigate the association between systemic low-grade inflammation and temporomandibular pain disorders, and the findings regarding men are new. Furthermore, little is known about the risk imposed by cynical hostility personality trait on developing chronic temporomandibular pain disorders, and the way through which that personality trait increases the risk of pain chronicity.

How can the results of your doctoral research be utilised in practice?

Understanding that temporomandibular pain is complex and multifaceted helps customizing treatments that provide better care according to patients' needs, thus increasing patients trust in the healthcare system and maximizing cost-effectiveness.

What are the key research methods and materials used in your doctoral research?

This research used the data from the Health 2000 and Health 2011 surveys that were conducted by the National Institute for Health and Welfare in Finland. The sample size comprised of those participating in the clinical oral examination of temporomandibular disorders in 2000 (n=6,309) and in 2011 (n=1,524). To investigate longitudinal effects, a sample of those who participated in both surveys was selected (n=1,210). Explanatory variables included age, sex, educational level, marital status, health status background (2000 and 2011), serum levels of high sensitivity C-reactive protein (hs-CRP) as marker of low-grade inflammation (2000 and 2011), Beck’s Depression Inventory-21 (BDI-21) (2000) and BDI-13 (2011) scores for the level of depressive symptoms, Cynical Distrust Scale score (2000 and 2011) for the level of cynical hostility, and the Symptom Checklist-90 somatization subscale (SCL-90-SOM) from 2000 for the level of somatization symptoms. Statistical analyses included Chi-square tests, logistic regression analyses, and mediation analyses.

The doctoral disseretation of Aisha Banafa, BDS, entitled Prevalence and biopsychosocial risk factors associated with temporomandibular pain: an 11-year follow-up study on Finnish adults will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Per Alstergren of Malmö University, and the Custos will be Professor Anna Liisa Suominen of the University of Eastern Finland.

Doctoral defence



For further information, please contact:

Aisha Banafa, BDS, aisha.banafa(a),